title: Clinical features and treatment outcomes of upper gastrointestinal bleeding in patients with cirrhosis.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Korea University College of Medicine, Sungbuk-gu, Seoul, Korea.
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Youn Ho
authors.initials: YH
authors.lastname: Kim
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Sang Kyun
authors.initials: SK
authors.lastname: Yu
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Jeong
authors.initials: J
authors.lastname: Heo
authors.forename: Taeho
authors.initials: T
authors.lastname: Hahn
authors.forename: Tae Woo
authors.initials: TW
authors.lastname: Yoo
authors.forename: Se Hyun
authors.initials: SH
authors.lastname: Cho
authors.forename: Hyun Woong
authors.initials: HW
authors.lastname: Lee
authors.forename: Ju Hyun
authors.initials: JH
authors.lastname: Kim
authors.forename: Mong
authors.initials: M
authors.lastname: Cho
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Byung Ik
authors.initials: BI
authors.lastname: Kim
authors.forename: Kwang Hyub
authors.initials: KH
authors.lastname: Han
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um