[Is the prognosis of patients with variceal hemorrhage determined by the severity of the underlying disease?].
This retrospective analysis includes all patients in whom endoscopic sclerotherapy was initiated because of bleeding oesophageal varices during the years 1984 to 1986. Of the total of 107 patients (77 men, 30 women, mean age 56 years) a majority of 71 (66.3%) had alcoholic liver disease as the underlying cause of portal hypertension. Varices were injected with ethoxysclerol 1% in weekly sessions if possible until they were completely eradicated. Initially 27 patients (25.2%) were classified as Child's class A, 52 (48.5%) as Child's class B and 27 as Child's class C. At the time of analysis 46 patients (42.9%) had died. 17 patients died of uncontrolled variceal haemorrhage one of them after a completed course of sclerotherapy, 15 died in hepatic coma. The cumulative survival rate after one year was 63.8% overall, 84.7% for patients in Child's class A, 75.4% for patients in Child's class B and 21.3% for patients in Child's class C. The one year survival rate for the 50 patients who failed to complete a course of sclerotherapy was 26.9%. The one year survival rate for alcoholics as a group (63%) was the same as for non-alcoholics (64.2%). 40 patients had non-fatal episodes of bleeding, 15 of whom bled after completion of a course of endoscopic sclerotherapy (median delay 174 days after completion of sclerotherapy). We conclude from our results that the outcome after sclerotherapy for oesophageal varices is determined mainly by the severity of the underlying liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Eigenmann
F
F
Gastroenterologische Abteilung des Inselspitals Bern.
Neff
A
A
van den Brandt-Grädel
V
V
Halter
F
F
D004932:Esophageal and Gastric Varices / Q000150:complications / Q000209:etiology* / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000401:mortality; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use
D012597:Sclerosing Solutions; D000077423:Polidocanol; D011092:Polyethylene Glycols
Ist die Prognose der Patienten mit Varizenblutung durch den Schweregrad der Grundkrankheit determiniert?