Copyright
©The Author(s) 2017.
World J Gastroenterol. Jan 21, 2017; 23(3): 496-504
Published online Jan 21, 2017. doi: 10.3748/wjg.v23.i3.496
Published online Jan 21, 2017. doi: 10.3748/wjg.v23.i3.496
Table 1 Baseline demographics and characteristics of patients with gastric fundal variceal bleeding
Parameters | n (%) |
Sex ratio (F/M) | 13/29 |
Mean age (yr) | 64.9 ± 11.6 |
Mean follow-up period (d) | 631 ± 109.6 |
History | |
Smoking (presence/absence) | 21/21 (50) |
Alcohol (presence/absence) | 20/22 (47.6) |
Disease conditions | |
Child-Pugh classification (A/B/C) | 4/20/18 |
Hepatocellular carcinoma (presence/absence) | 14/28 (33.3) |
Hepatic encephalopathy (presence/absence) | 6/36 (14.3) |
Form of gastric fundal varices (F1-F2/F3) | 4/38 |
Concurrent esophageal varices (presence/absence) | 30/12 (71.4) |
Previous treatment of gastric varices (presence/absence) | 1/41 (2.4) |
Etiology of liver cirrhosis | |
Hepatitis B | 5 (11.9) |
Hepatitis C | 18 (42.9) |
Alcoholic | 12 (28.6) |
Others | 7 (16.6) |
Treatment of gastric fundal varices | |
Success of initial treatment (total success/total failure) | 39/3 (92.9) |
Endoscopic treatment (EIS) (success/failure) | 30/1 (96.7) |
Nonendoscopic treatment (success/failure) | 8/1 (11.1) |
Not applicable | 1/1 (50) |
Antibiotics (presence/absence) | 23/19 (54.8) |
Blood transfusion (presence/absence) | 38/4 (90.5) |
Rebleeding after initial treatment (presence/absence) | 10/32 (23.8) |
Medications administered before admission | |
NSAIDs (presence/absence) | 5/37 (11.9) |
Anticoagulants (presence/absence) | 1/41 (2.4) |
Proton pump inhibitors (presence/absence) | 14/28 (33.3) |
Blood test results | |
Hemoglobin (g/dL) | 8.7 ± 1.8 |
Albumin (g/dL) | 2.54 ± 0.44 |
Bilirubin (mg/dL) | 1.98 ± 1.44 |
Table 2 Factors associated with 90-d mortality related to gastric fundal variceal bleeding
Parameters | Univariate analysis | Multivariate analysis | ||||||
β | P value | R | HR (95%CI) | β | P value | R | HR (95%CI) | |
Sex (F/M) | 0.2393 | 0.7354 | 0 | 1.27 (0.32-5.09) | ||||
Age (yr) | 0.0291 | 0.3215 | 0 | 1.03 (0.97-1.09) | ||||
History | ||||||||
Smoking | 0.5698 | 0.4208 | 0 | 1.77 (0.44-7.08) | ||||
Alcohol | 0.1163 | 0.8624 | 0 | 0.89 (0.24-3.32) | ||||
Disease conditions | ||||||||
Child-Pugh classification (C/B/A) | 0.7513 | 0.1991 | 0 | 2.12 (0.67-6.67) | ||||
Hepatocellular carcinoma | 1.6422 | 0.02091 | 0.23 | 5.17 (1.28-20.8) | 2.3041 | 0.00921 | 0.28 | 10.01 (1.77-56.74) |
Hepatic encephalopathy | 0.8163 | 0.3115 | 0 | 2.26 (0.47-10.99) | ||||
Form of GFV (F2 or F3/F1) | −0.263 | 0.8046 | 0 | 0.77 (0.10-6.16) | ||||
Concurrent esophageal varices | −0.233 | 0.7422 | 0 | 0.79 (0.20-3.17) | ||||
Etiology of liver cirrhosis (non-viral/viral) | −1.215 | 0.1302 | −0.07 | 0.30 (0.06-1.43) | ||||
Treatment of GFV | ||||||||
Success of initial treatment | −2.176 | 0.00811 | −0.28 | 0.11 (0.02-0.57) | ||||
Initial treatment (non-EIS/EIS/none) | 0.0253 | 0.9726 | 0 | 1.03 (0.24-4.36) | ||||
Antibiotics | −1.637 | 0.04131 | −0.18 | 0.19 (0.04-0.94) | −2.5412 | 0.00861 | −0.28 | 0.08 (0.01-0.52) |
Blood transfusion | 3.1861 | 0.4892 | 0 | 1.96 (0.32-14.68) | ||||
Rebleeding after initial treatment | 1.5956 | 0.01771 | 0.24 | 4.94 (1.32-18.42) | ||||
Medications before admission | ||||||||
NSAIDs | 0.5802 | 0.4697 | 0 | 1.79 (0.37-8.61) | ||||
Proton pump inhibitors | 1.5316 | 0.03061 | 0.2 | 4.63 (1.15-18.53) | 2.5465 | 0.00531 | 0.29 | 12.76 (2.13-76.52) |
Blood test results | ||||||||
Hemoglobin (g/dL) | −0.012 | 0.9458 | 0 | 0.99 (0.70-1.39) | ||||
Albumin (g/dL) | −1.429 | 0.0951 | −0.11 | 0.24 (0.04-1.28) | ||||
Bilirubin (mg/dL) | 0.1916 | 0.3572 | 0 | 1.21 (0.81-1.82) |
Table 3 Factors associated with overall survival related to gastric fundal variceal bleeding
Parameters | Univariate analysis | Multivariate analysis | ||||||
β | P value | R | HR (95%CI) | β | P value | R | HR (95%CI) | |
Sex (F/M) | 0.1107 | 0.8404 | 0 | 1.12 (0.38-3.28) | ||||
Age (yr) | 0.0152 | 0.5056 | 0 | 0.98 (0.94-1.03) | ||||
History | ||||||||
Smoking | 0.5678 | 0.3014 | 0 | 1.76 (0.60-5.18) | ||||
Alcohol | 0.3031 | 0.5591 | 0 | 1.35 (0.49-3.74) | ||||
Disease conditions | ||||||||
Child-Pugh classification (C/B/A) | 0.9924 | 0.03661 | 0.15 | 2.70 (1.06-6.84) | ||||
Hepatocellular carcinoma | 1.8351 | 0.00131 | 0.29 | 6.27 (2.05-19.17) | 2.0666 | 0.00351 | 0.26 | 7.89 (1.98-31.58) |
Hepatic encephalopathy | 0.5089 | 0.4391 | 0 | 1.66 (0.46-6.04) | ||||
Form of GFV (F2 or F3/F1) | 0.3475 | 0.7379 | 0 | 1.42 (0.18-10.85) | ||||
Concurrent esophageal varices | −0.098 | 0.8596 | 0 | 0.91 (0.31-2.67) | ||||
Etiology of liver cirrhosis (non-viral/viral) | −0.086 | 0.8688 | 0 | 0.92 (0.33-2.54) | ||||
Treatment of GFV | ||||||||
Success of initial treatment | −2.176 | 0.00811 | −0.22 | 0.11 (0.02-0.57) | ||||
Initial treatment (non-EIS/EIS/none) | 0.0496 | 0.9356 | 0 | 1.05 (0.32-3.50) | ||||
Antibiotics | −0.81 | 0.0512 | −0.07 | 0.44 (0.16-1.25) | −1.3103 | 0.03411 | −0.16 | 0.27 (0.08-0.91) |
Blood transfusion | 0.5432 | 0.6012 | 0 | 1.72 (0.22-13.18) | ||||
Rebleeding after initial treatment | 1.3669 | 0.00871 | 0.22 | 3.92 (1.41-10.89) | ||||
Medications administered before admission | ||||||||
NSAIDs | 1.0131 | 0.0877 | 0.1 | 2.75 (0.86-8.81) | 1.2391 | 0.1184 | 0.07 | 3.45 (0.73-16.35) |
Proton pump inhibitors | 1.4012 | 0.00841 | 0.22 | 4.06 (1.43-11.52) | 2.3901 | 0.00051 | 0.32 | 10.91 (2.86-41.65) |
Blood test results | ||||||||
Hemoglobin (g/dL) | −0.062 | 0.6398 | 0 | 0.94 (0.72-1.22) | ||||
Albumin (g/dL) | −1.081 | 0.0915 | −0.09 | 0.34 (0.10-1.19) | ||||
Bilirubin (mg/dL) | 0.3065 | 0.0514 | 0.13 | 1.36 (0.99-1.85) | 0.4224 | 0.0535 | 0.13 | 1.53 (0.99-2.34) |
Table 4 Baseline characteristics of patients with gastric fundal variceal bleeding in the antibiotic vs nonantibiotic group
Parameters | Antibiotic group | Non-antibiotic group | P value |
(n = 23) | (n = 19) | ||
Sex ratio (F/M) | 5/18 | 8/11 | 0.1925 |
Mean age (yr) | 64.4 ± 13.07 | 65.47 ± 9.83 | 0.7673 |
History | |||
Smoking (presence/absence) | 12/11 | 9/10 | 1 |
Alcohol (presence/absence) | 12/11 | 8/11 | 0.5512 |
Disease conditions | |||
Child-Pugh classification (A/B/C) | 2/13/8 | 2/7/10 | NA |
Hepatocellular carcinoma (presence/absence) | 7/16 | 7/12 | 0.7483 |
Hepatic encephalopathy (presence/absence) | 1/22 | 5/14 | 0.0754 |
Form of gastric fundal varices ( F2-F3/F1) | 21/2 | 17/2 | 1 |
Concurrent esophageal varices (presence/absence) | 17/6 | 13/6 | 0.7422 |
Previous treatment of GV (presence/absence) | 0/23 | 1/18 | 0.4524 |
Etiology of liver cirrhosis | |||
Non-viral/viral | 9/14 | 10/9 | 0.5347 |
Treatment of gastric fundal varices | |||
Success of initial treatment (success/failure) | 22/1 | 17/2 | 0.5813 |
Antibiotics (presence/absence) | 23/0 | 0/19 | < 0.0001a |
Blood transfusion (presence/absence) | 22/1 | 16/3 | 0.3129 |
Medications before admission | |||
NSAIDs (presence/absence) | 2/21 | 3/16 | 0.6440 |
Anticoagulant (presence/absence) | 0/23 | 1/18 | 0.4524 |
Proton pump inhibitors (presence/absence) | 8/15 | 6/13 | 1 |
Blood test results | |||
Hemoglobin (g/dL) | 8.97 ± 1.99 | 8.30 ± 1.63 | 0.2472 |
Albumin (g/dL) | 2.56 ± 0.47 | 2.50 ± 0.39 | 0.6125 |
Bilirubin (mg/dL) | 1.89 ± 1.41 | 2.09 ± 1.49 | 0.6616 |
Table 5 Baseline demographics and characteristics of patients in the proton pump inhibitors vs non- proton pump inhibitors group
Parameters | PPI group | Non-PPI group | P value |
(n = 14) | (n = 28) | ||
Sex ratio (F/M) | 6/8 | 7/21 | 0.2980 |
Mean age (yr) | 61.9 ± 13.36 | 66.4 ± 10.53 | 0.2364 |
History | |||
Smoking (presence/absence) | 8/6 | 13/15 | 0.7442 |
Alcohol (presence/absence) | 7/7 | 13/15 | 1 |
Disease conditions | |||
Child-Pugh classification (A/B/C) | 0/6/8 | 4/14/10 | 0.2122 |
Hepatocellular carcinoma (presence/absence) | 6/8 | 8/20 | 0.4899 |
Hepatic encephalopathy (presence/absence) | 2/12 | 4/24 | 1 |
Form of gastric fundal varices (F2-F3/F1) | 2/12 | 2/26 | 0.5902 |
Concurrent esophageal varices (presence/absence) | 7/7 | 23/5 | 0.0666 |
Previous treatment of GV (presence/absence) | 0/14 | 1/27 | 1 |
Etiology of liver cirrhosis | |||
Non-viral/viral | 4/10 | 15/13 | 0.1905 |
Treatment of gastric fundal varices | |||
Success of initial treatment (success/failure) | 12/2 | 27/1 | 0.2537 |
Antibiotics (presence/absence) | 8/6 | 15/13 | 1 |
Blood transfusion (presence/absence) | 13/1 | 25/3 | 1 |
Medications before admission | |||
NSAIDs (presence/absence) | 4/24 | 1/13 | 0.6496 |
Anticoagulants (presence/absence) | 1/13 | 0/28 | 0.3333 |
Proton pump inhibitors (presence/absence) | 14/0 | 0/28 | < 0.0001a |
Blood test results | |||
Hemoglobin (g/dL) | 8.65 ± 1.59 | 8.68 ± 1.99 | 0.4792 |
Albumin (g/dL) | 2.34 ± 0.39 | 2.64 ± 0.43 | 0.0314a |
Bilirubin (mg/dL) | 2.00 ± 1.39 | 1.97 ± 1.48 | 0.5238 |
- Citation: Komori K, Kubokawa M, Ihara E, Akahoshi K, Nakamura K, Motomura K, Masumoto A. Prognostic factors associated with mortality in patients with gastric fundal variceal bleeding. World J Gastroenterol 2017; 23(3): 496-504
- URL: https://www.wjgnet.com/1007-9327/full/v23/i3/496.htm
- DOI: https://dx.doi.org/10.3748/wjg.v23.i3.496