Bedside risk‐scoring model for predicting 6‐week mortality in cirrhotic patients undergoing endoscopic band ligation for acute variceal bleeding

2021 ◽  
Author(s):  
Jung Hee Kim ◽  
Se Woo Park ◽  
Jang Han Jung ◽  
Da Hae Park ◽  
Chang Seok Bang ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Scoring Model ◽  
Band Ligation ◽  
Acute Variceal Bleeding ◽  
Risk Scoring ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation

scholarly journals Endoscopic band ligation versus propranolol for the primary prophylaxis of variceal bleeding in cirrhotic patients with high risk esophageal varices

2010 ◽  
Vol 9 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Rosa María Pérez-Ayuso ◽  
Sebastián Valderrama ◽  
Manuel Espinoza ◽  
Antonio Rollán ◽  
René Sánchez ◽  
...  
Keyword(s):  
High Risk ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Primary Prophylaxis ◽  
Band Ligation ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation

scholarly journals Comparative Efficacy of Terlipressin and Octreotide along with Endoscopic Band Ligation in the Management of Esophageal Variceal Bleeding

2021 ◽  
Vol 2 (2) ◽  
pp. 41-48
Author(s):  
Sadia Asif ◽  
Ayesha Shehbaz Khan ◽  
Sarmad Zahoor ◽  
Hafiz Mudabbar Mahboob ◽  
Uzma Malik ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Medical Emergency ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Band Ligation ◽  
Female Patients ◽  
Group A ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation ◽  
Group B

Esophageal variceal bleeding is a medical emergency that carries a high mortality rate despite appropriate management. Terlipressin and Octreotide are two common agents used as adjuvant agents in the management of variceal bleeding. The objective of this study is to compare the effectiveness of Terlipressin with Octreotide along with endoscopic band ligation in the management of esophageal variceal bleeding in cirrhotic patients. This randomized control study was carried out at the Department of General Medicine, Fatima Memorial Hospital, Lahore, for six months extending from February 2019 to July 2019. A total of 100 cirrhotic patients were selected /based on predetermined inclusion and exclusion criteria. The patients were randomly divided into two groups of equal strength. Hence, 50 patients were included in Group A and 50 patients were included in Group B along with banding. Group A received Terlipressin whereas Group B received Octreotide. The two groups were monitored for variceal bleeding for 72 hours. The mean age of the patients in Group A was 55.9±7.3 years and for the patients in Group B it was 56.8±7.4 years. In Group A, 36 (72.0%) male and 14 (28.0%) female patients were included. In Group B, there were 34 (68.0%) male and 16 (32.0%) female patients. In Group A, the treatment was effective for 46 (92.0%) patients and in Group B, 36 (72.0%) patients had an effective treatment. It is concluded from this study that Terlipressin is statistically more effective than Octerotide in terms of preventing esophageal variceal bleeding.

scholarly journals Comparative Efficacy of Terlipressin and Octreotide along with Endoscopic Band Ligation in the Management of Esophageal Variceal Bleeding

2020 ◽  
Vol 2 (2) ◽  
pp. 41-48
Author(s):  
Sadia Asif ◽  
Ayesha Shehbaz Khan ◽  
Sarmad Zahoor ◽  
Hafiz Mudabbar Mahboob ◽  
Uzma Malik ◽  
...  
Keyword(s):  
Variceal Bleeding ◽  
Medical Emergency ◽  
Esophageal Variceal ◽  
Esophageal Variceal Bleeding ◽  
Band Ligation ◽  
Female Patients ◽  
Group A ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation ◽  
Group B

Esophageal variceal bleeding is a medical emergency that carries a high mortality rate despite appropriate management. Terlipressin and Octreotide are two common agents used as adjuvant agents in the management of variceal bleeding. The objective of this study is to compare the effectiveness of Terlipressin with Octreotide along with endoscopic band ligation in the management of esophageal variceal bleeding in cirrhotic patients. This randomized control study was carried out at the Department of General Medicine, Fatima Memorial Hospital, Lahore, for six months extending from February 2019 to July 2019. A total of 100 cirrhotic patients were selected /based on predetermined inclusion and exclusion criteria. The patients were randomly divided into two groups of equal strength. Hence, 50 patients were included in Group A and 50 patients were included in Group B along with banding. Group A received Terlipressin whereas Group B received Octreotide. The two groups were monitored for variceal bleeding for 72 hours. The mean age of the patients in Group A was 55.9±7.3 years and for the patients in Group B it was 56.8±7.4 years. In Group A, 36 (72.0%) male and 14 (28.0%) female patients were included. In Group B, there were 34 (68.0%) male and 16 (32.0%) female patients. In Group A, the treatment was effective for 46 (92.0%) patients and in Group B, 36 (72.0%) patients had an effective treatment. It is concluded from this study that Terlipressin is statistically more effective than Octerotide in terms of preventing esophageal variceal bleeding.

Endoscopic Band Ligation and Esophageal Stents for Acute Variceal Bleeding

2014 ◽  
Vol 18 (4) ◽  
pp. 793-808 ◽  
Author(s):  
Andrés Cárdenas ◽  
Alejandro Fernández-Simon ◽  
Angels Escorcell
Keyword(s):  
Variceal Bleeding ◽  
Esophageal Stents ◽  
Band Ligation ◽  
Acute Variceal Bleeding ◽  
Endoscopic Band Ligation

PROGNOSTIC VALUE OF COMBINATION AIMS65 AND MELD SCORES IN CIRRHOTIC PATIENTS WITH ACUTE VARICEAL BLEEDING

2019 ◽  
pp. 35-40
Author(s):  
Thi Nhung Nguyen ◽  
Trung Nam Phan ◽  
Van Huy Tran
Keyword(s):  
Clinical Practice ◽  
Portal Hypertension ◽  
Key Words ◽  
Variceal Bleeding ◽  
Prognostic Value ◽  
High Rate ◽  
Central Hospital ◽  
Acute Variceal Bleeding ◽  
Cirrhotic Patients ◽  
Sensitivity Specificity

Bacground: Variceal bleeding is a severe complication of portal hypertension due to cirrhosis with high rate of motality, hence, predicting early rebleeding and mortality in cirrhotic patients with acute variceal bleeding is vital in clinical practice. Objectives: To evaluate the prognostic value of the combination of AIMS65 and MELD scores in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding. Materials and Methods: 44 cirrhotic patients with acute variceal bleeding hospitalized at Hue Central Hospital. MELD and AIMS65 scores were calculated within the first 24 hours and monitoring rebleeding and mortality in the first 5 days in these patients. Results: AIMS65, MELD scores can predict first 5 days rebleeding and mortality with AUROC are 0.81, 0.69 and 0.92, 0.95, respectively. Combination of AIMS65 and MELD scores can predict first 5 days in hospital rebleeding with AUROC is 0.84, sensitivity 83.3%, specificity 81.6% (p<0.001) and mortality with AUROC is 0.96, sensitivity 100%, specificity 92.7% (p<0.001). Conclusions: The combination of AIMS65 and MELD scores increased the sensitivity, specificity and prognostic value in predicting first 5 days in-hospital rebleeding and mortality in cirrhotic patients with acute variceal bleeding in compare to each single scores. Key words: AiMS65 score, MELd, acute variceal bleeding

scholarly journals Performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Rehab Elsayed Elsafty ◽  
Abdallah Ahmed Elsawy ◽  
Ahmed Fawzy Selim ◽  
Atef Mohamed Taha
Keyword(s):  
Hepatic Encephalopathy ◽  
Variceal Bleeding ◽  
Early Discharge ◽  
Meld Score ◽  
Bleeding Control ◽  
Acute Variceal Bleeding ◽  
Prophylactic Measures ◽  
Significant Performance ◽  
Cirrhotic Patients ◽  
Grade 3

Abstract Background Hepatic encephalopathy exacerbates the morbidity, delays hospital discharge, and increases the rate of readmissions of cirrhotic patients, particularly those are admitted by acute variceal bleeding. We evaluated the performance of albumin-bilirubin score in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding, in comparison to Child-Pugh and MELD scores. This prospective cohort study was conducted on 250 cirrhotic patients who were consecutively presented by acute variceal bleeding in the period from January to December 2020 at Tanta university emergency hospital. Albumin-bilirubin, Child-Pugh, and MELD scores were measured at admission, and then all patients were followed up for 4 weeks after endoscopic bleeding control for possible occurrence of hepatic encephalopathy Results Albumin-bilirubin, Child-Pugh, and MELD scores had significant performances in prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding; in this regard, albumin-bilirubin score had the highest accuracy (AUC 0.858, CI 0.802-0.914, sig 0.000) followed by Child-Pugh score (AUC 0.654, CI 0.574–0.735, sig 0.001) and then MELD score (AUC 0.602, CI 0.519–0.686, sig 0.031). The cumulative incidence of hepatic encephalopathy in cirrhotic patients with albumin-bilirubin grade 3 was found to be significantly more than that present in albumin-bilirubin grade 2; most of these hepatic encephalopathy cases occurred in the first 2 weeks of follow-up period. Conclusions Albumin-bilirubin score has a significant performance in risk prediction of hepatic encephalopathy in cirrhotic patients with acute variceal bleeding better than Child-Pugh and MELD scores. Albumin-bilirubin grades could be used as a risk stratifying tool to triage cirrhotic patients who will benefit from early discharge after bleeding control and those patients who will benefit from prophylactic measures for hepatic encephalopathy.

Covered TIPS versus endoscopic band ligation plus propranolol for the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis: a randomised controlled trial

Gut ◽  
2017 ◽  
Vol 67 (12) ◽  
pp. 2156-2168 ◽  
Author(s):  
Yong Lv ◽  
Xingshun Qi ◽  
Chuangye He ◽  
Zhengyu Wang ◽  
Zhanxin Yin ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Adverse Events ◽  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Decompensated Cirrhosis ◽  
Covered Stents ◽  
Band Ligation ◽  
Vein Thrombosis ◽  
Cirrhotic Patients ◽  
Endoscopic Band Ligation

ObjectiveLimited data are available on the prevention of variceal rebleeding in cirrhotic patients with portal vein thrombosis (PVT). This study aimed to compare transjugular intrahepatic portosystemic shunt (TIPS) with covered stents versus endoscopic band ligation (EBL) plus propranolol for the prevention of variceal rebleeding among patients with cirrhosis and PVT.DesignConsecutive cirrhotic patients (94% Child-Pugh class A or B) with PVT who had variceal bleeding in the past 6 weeks were randomly assigned to TIPS group (n=24) or EBL plus propranolol group (EBL+drug, n=25), respectively. Primary endpoint was variceal rebleeding. Secondary endpoints included survival, overt hepatic encephalopathy (OHE), portal vein recanalisation and rethrombosis, other complications of portal hypertension and adverse events.ResultsDuring a median follow-up of 30 months in both groups, variceal rebleeding was significantly less frequent in the TIPS group (15% vs 45% at 1 year and 25% vs 50% at 2 years, respectively; HR=0.28, 95% CI 0.10 to 0.76, p=0.008), with a significantly higher portal vein recanalisation rate (95% vs 70%; p=0.03) and a relatively lower rethrombosis rate (5% vs 33%; p=0.06) compared with the EBL+drug group. There were no statistically significant differences in survival (67% vs 84%; p=0.152), OHE (25% vs 16%; p=0.440), other complications of portal hypertension and adverse events between groups.ConclusionCovered TIPS placement in patients with PVT and moderately decompensated cirrhosis was more effective than EBL combined with propranolol for the prevention of rebleeding, with a higher probability of PVT resolution without increasing the risk of OHE and adverse effects, but this benefit did not translate into improved survival.Trial registration numberClinicalTrials.gov: NCT01326949.

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