Published online Apr 27, 2018. doi: 10.4240/wjgs.v10.i4.40
Peer-review started: February 7, 2018
First decision: February 28, 2018
Revised: March 9, 2018
Accepted: April 11, 2018
Article in press: April 11, 2018
Published online: April 27, 2018
Core tip: We investigated adherence to surveillance endoscopy in 99 consecutive patients with cirrhosis who survived esophageal variceal bleeding, and the extent to which adherence influenced outcomes. We found that the minority (33%) completed variceal obliteration and fewer (12%) underwent annual surveillance. Completion of obliteration was associated with fewer and later rehospitalizations for variceal rebleeding. Those non-adherent to annual surveillance were more likely to be uninsured or to have coverage through Medicaid assistance. Our findings identify potential markers for socioeconomic factors that limit endoscopic adherence following variceal hemorrhage and lead to adverse outcomes. New approaches are needed to overcome barriers to adherence.