title: Clinical features and outcomes of gastric variceal bleeding: retrospective Korean multicenter data.
abstract: OBJECTIVE
  While gastric variceal bleeding (GVB) is not as prevalent as esophageal variceal bleeding, it is reportedly more serious, with high failure rates of the initial hemostasis (>30%), and has a worse prognosis than esophageal variceal bleeding. However, there is limited information regarding hemostasis and the prognosis for GVB. The aim of this study was to determine retrospectively the clinical outcomes of GVB in a multicenter study in Korea.
  
  
  METHODS
  The data of 1,308 episodes of GVB (males:females=1062:246, age=55.0±11.0 years, mean±SD) were collected from 24 referral hospital centers in South Korea between March 2003 and December 2008. The rates of initial hemostasis failure, rebleeding, and mortality within 5 days and 6 weeks of the index bleed were evaluated.
  
  
  RESULTS
  The initial hemostasis failed in 6.1% of the patients, and this was associated with the Child-Pugh score [odds ratio (OR)=1.619; P<0.001] and the treatment modality: endoscopic variceal ligation, endoscopic variceal obturation, and balloon-occluded retrograde transvenous obliteration vs. endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and balloon tamponade (OR=0.221, P<0.001). Rebleeding developed in 11.5% of the patients, and was significantly associated with Child-Pugh score (OR=1.159, P<0.001) and treatment modality (OR=0.619, P=0.026). The GVB-associated mortality was 10.3%; mortality in these cases was associated with Child-Pugh score (OR=1.795, P<0.001) and the treatment modality for the initial hemostasis (OR=0.467, P=0.001).
  
  
  CONCLUSIONS
  The clinical outcome for GVB was better for the present cohort than in previous reports. Initial hemostasis failure, rebleeding, and mortality due to GVB were universally associated with the severity of liver cirrhosis.
authors.affiliation: Department of Internal Medicine and Cell Therapy and Tissue Engineering Center, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Moon Young
authors.initials: MY
authors.lastname: Kim
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Soon Koo
authors.initials: SK
authors.lastname: Baik
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Park
authors.forename: Jung Il
authors.initials: JI
authors.lastname: Lee
authors.forename: Jin Woo
authors.initials: JW
authors.lastname: Lee
authors.forename: Gab Jin
authors.initials: GJ
authors.lastname: Cheon
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Sohn
authors.forename: Tae Yeob
authors.initials: TY
authors.lastname: Kim
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Lim
authors.forename: Tae Hyo
authors.initials: TH
authors.lastname: Kim
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Lee
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Park
authors.forename: Seung Ha
authors.initials: SH
authors.lastname: Park
authors.forename: Jin Dong
authors.initials: JD
authors.lastname: Kim
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Han
authors.forename: Chang Soo
authors.initials: CS
authors.lastname: Choi
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Cho
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Hwang
authors.forename: Byoung Kuk
authors.initials: BK
authors.lastname: Jang
authors.forename: June Sung
authors.initials: JS
authors.lastname: Lee
authors.forename: Sang Gyune
authors.initials: SG
authors.lastname: Kim
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: So Young
authors.initials: SY
authors.lastname: Kwon
authors.forename: Won Hyeok
authors.initials: WH
authors.lastname: Choe
authors.forename: Chang Hyeong
authors.initials: CH
authors.lastname: Lee
authors.forename: Byung Seok
authors.initials: BS
authors.lastname: Kim
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Soung Won
authors.initials: SW
authors.lastname: Jeong
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Kim
authors.forename: Jae Jun
authors.initials: JJ
authors.lastname: Shim
authors.forename: Yong Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Koh
authors.forename: Hyun Woong
authors.initials: HW
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D004724:Endoscopy; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D056910:Republic of Korea; D012189:Retrospective Studies; D015911:Sclerotherapy; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cirrhosis; Gastric variceal bleeding; Mortality; Rebleeding