Outcomes of patients treated with Sengstaken-Blakemore tube for uncontrolled variceal hemorrhage.
- Author:
Ja Yun CHOI
1
;
Yun Won JO
;
Sang Soo LEE
;
Wan Soo KIM
;
Hye Won OH
;
Cha Young KIM
;
Eun Young YUN
;
Jin Joo KIM
;
Jae Min LEE
;
Hong Jun KIM
;
Hyun Jin KIM
;
Tae Hyo KIM
;
Woon Tae JUNG
;
Ok Jae LEE
;
Rock Bum KIM
Author Information
- Publication Type:Original Article
- Keywords: Variceal hemorrhage; Sengstaken-Blakemore tube; Mortality; Hemostasis
- MeSH: Hemodynamics; Hemorrhage*; Hemostasis; Humans; Incidence; Intubation, Intratracheal; Ligation; Mortality; Retrospective Studies; Rupture; Salvage Therapy
- From:The Korean Journal of Internal Medicine 2018;33(4):696-704
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment. METHODS: The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed. RESULTS: The overall success rate of initial hemostasis with SB tube was 75.8%, and the independent factors associated with hemostasis were non-intubated state before SB tube (odds ratio, 8.50; p = 0.007) and Child-Pugh score < 11 (odds ratio, 15.65; p = 0.022). Rebleeding rate after successful initial hemostasis with SB tube was 22.0%, and esophageal rupture occurred in 6.1%. Mortality within 30 days was 42.4%, and the related independent factors with mortality were failure of initial hemostasis with SB tube (hazard ratio, 6.24; p < 0.001) and endotracheal intubation before SB tube (hazard ratio, 2.81; p = 0.018). CONCLUSIONS: Since the era of endoscopic band ligation, SB tube might be a beneficial option as a temporary salvage treatment for uncontrolled variceal hemorrhage. However, rescue therapy had a high incidence of fatal complication and rebleeding.
