Risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding

ObjectiveTo investigate the rebleeding rate after endoscopic selective variceal devascularization (ESVD) and the predictive factors for rebleeding in patients with hepatitis B cirrhosis and esophageal variceal bleeding (EVB). MethodsThe patients with hepatitis B cirrhosis and EVB who attended Beijin...

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Autor principal:	MA Jiali
Formato:	article
Lenguaje:	ZH
Publicado:	Editorial Department of Journal of Clinical Hepatology 2021
Materias:	Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/3545b10d7fc34d8dbeaf6eb97592d536
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spelling	oai:doaj.org-article:3545b10d7fc34d8dbeaf6eb97592d5362021-11-17T10:54:33ZRisk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding1001-5256https://doaj.org/article/3545b10d7fc34d8dbeaf6eb97592d5362021-11-01T00:00:00Zhttp://www.lcgdbzz.org/cn/article/doi/10.3969/j.issn.1001-5256.2021.11.017https://doaj.org/toc/1001-5256ObjectiveTo investigate the rebleeding rate after endoscopic selective variceal devascularization (ESVD) and the predictive factors for rebleeding in patients with hepatitis B cirrhosis and esophageal variceal bleeding (EVB). MethodsThe patients with hepatitis B cirrhosis and EVB who attended Beijing Ditan Hospital, Capital Medical University, from October 2010 to December 2019 and underwent ESVD for the first time were enrolled, and a total of 442 patients were screened out based on inclusion and exclusion criteria. Routine clinical indices, laboratory markers, imaging findings, and endoscopic findings were compared between patients, and the patients were followed up to observe rebleeding. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to describe rebleeding and survival status, and a Cox regression analysis was used to determine the independent risk factors for variceal rebleeding. ResultsThe 1-, 2-, 3-, 4-, and 5-year cumulative rebleeding rates after first ESVD treatment were 25.11%, 33.94%, 39.82%, 42.08%, and 45.02%, respectively. The univariate analysis showed that age, systolic pressure, duration of antiviral therapy ≥1 year, ascites, white blood cell count, neutrophil, and direct bilirubin were associated with rebleeding (all P＜0.05), and the multivariate analysis showed that duration of antiviral therapy ≥1 year (hazard ratio ［HR］=0.504, 95% confidence interval ［CI］: 0.357-0.711, P＜0.001) and ascites (HR=1.424, 95%CI: 1.184-1.714, P＜0.001) were independent influencing factors for variceal rebleeding. ConclusionESVD has a low rebleeding rate in the treatment of hepatitis B cirrhosis with EVB, and presence of ascites and a short duration of antiviral therapy are independent risk factors for rebleeding after treatment.MA JialiEditorial Department of Journal of Clinical HepatologyarticleDiseases of the digestive system. GastroenterologyRC799-869ZHLinchuang Gandanbing Zazhi, Vol 37, Iss 11, Pp 2569-2574 (2021)
institution	DOAJ
collection	DOAJ
language	ZH
topic	Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Diseases of the digestive system. Gastroenterology RC799-869 MA Jiali Risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding
description	ObjectiveTo investigate the rebleeding rate after endoscopic selective variceal devascularization (ESVD) and the predictive factors for rebleeding in patients with hepatitis B cirrhosis and esophageal variceal bleeding (EVB). MethodsThe patients with hepatitis B cirrhosis and EVB who attended Beijing Ditan Hospital, Capital Medical University, from October 2010 to December 2019 and underwent ESVD for the first time were enrolled, and a total of 442 patients were screened out based on inclusion and exclusion criteria. Routine clinical indices, laboratory markers, imaging findings, and endoscopic findings were compared between patients, and the patients were followed up to observe rebleeding. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to describe rebleeding and survival status, and a Cox regression analysis was used to determine the independent risk factors for variceal rebleeding. ResultsThe 1-, 2-, 3-, 4-, and 5-year cumulative rebleeding rates after first ESVD treatment were 25.11%, 33.94%, 39.82%, 42.08%, and 45.02%, respectively. The univariate analysis showed that age, systolic pressure, duration of antiviral therapy ≥1 year, ascites, white blood cell count, neutrophil, and direct bilirubin were associated with rebleeding (all P＜0.05), and the multivariate analysis showed that duration of antiviral therapy ≥1 year (hazard ratio ［HR］=0.504, 95% confidence interval ［CI］: 0.357-0.711, P＜0.001) and ascites (HR=1.424, 95%CI: 1.184-1.714, P＜0.001) were independent influencing factors for variceal rebleeding. ConclusionESVD has a low rebleeding rate in the treatment of hepatitis B cirrhosis with EVB, and presence of ascites and a short duration of antiviral therapy are independent risk factors for rebleeding after treatment.
format	article
author	MA Jiali
author_facet	MA Jiali
author_sort	MA Jiali
title	Risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding
title_short	Risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding
title_full	Risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding
title_fullStr	Risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding
title_full_unstemmed	Risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding
title_sort	risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis b cirrhosis and acute variceal bleeding
publisher	Editorial Department of Journal of Clinical Hepatology
publishDate	2021
url	https://doaj.org/article/3545b10d7fc34d8dbeaf6eb97592d536
work_keys_str_mv	AT majiali riskfactorsforrebleedingafterendoscopicselectivevaricealdevascularizationinpatientswithhepatitisbcirrhosisandacutevaricealbleeding
_version_	1718425601811939328

Risk factors for rebleeding after endoscopic selective variceal devascularization in patients with hepatitis B cirrhosis and acute variceal bleeding

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