Clinical features and treatment outcomes of upper gastrointestinal bleeding in patients with cirrhosis.
With recent progress in treatment modalities, mortality from upper gastrointestinal (UGI) bleeding has decreased appreciably. The aim of this study was to establish how UGI bleeds are managed in Korean patients with cirrhosis and to evaluate treatment outcomes. A total of 479 episodes of acute UGI bleeding in 464 patients with cirrhosis were included during a six-month period at nine tertiary medical centers. Treatment outcomes were assessed by failure to control bleeding, rebleeding and mortality. The source of bleeding was esophagogastric varices in 77.7% of patients, nonvariceal lesions in 15.9%, and undefined in 6.5%. For control of bleeding, endoscopic and pharmacologic treatments were used in 74.7% and 81.9% of patients, respectively. Variceal ligation was a major technique for endoscopic treatment (90%), and terlipressin and somatostatin were the main pharmacologic agents used (96.4%). Initial hemostasis was achieved in 86.8% of cases, but rebleeding occurred in 3.8% and 16.8% of cases within five days and six weeks of hemorrhage, respectively. Five-day and six-week mortality were 11.3% and 25.9%, respectively. Survival of patients with variceal bleeding seems to be remarkably improved than previous reports, which may suggest the advances in hemostatic methods for control of variceal hemorrhage.
Seo
Yeon Seok
YS
Department of Internal Medicine, Korea University College of Medicine, Sungbuk-gu, Seoul, Korea.
Kim
Youn Ho
YH
Ahn
Sang Hoon
SH
Yu
Sang Kyun
SK
Baik
Soon Koo
SK
Choi
Sung Kyu
SK
Heo
Jeong
J
Hahn
Taeho
T
Yoo
Tae Woo
TW
Cho
Se Hyun
SH
Lee
Hyun Woong
HW
Kim
Ju Hyun
JH
Cho
Mong
M
Park
Sang Hoon
SH
Kim
Byung Ik
BI
Han
Kwang Hyub
KH
Um
Soon Ho
SH