Abstract | BACKGROUND: METHODS: We analyzed real-life data of cirrhotic patients undergoing elective EBL at two large Viennese centers between Q1/2000-Q1/2018. PRB was defined as bleeding occurring within 30 days after EBL. RESULTS: We included 617 patients undergoing a total of 1178 prophylactic EBL procedures (median 2 per patient). Sixteen (2.6%) of 617 patients experienced PRB after a median of 12.5 (IQR 17.3) days with no difference in characteristics and laboratory values between the two groups. The proportion of patients with platelets (PLT) < 50 G/L or INR ≥ 1.5 was similar in patients with vs. without PRB. A higher MELD showed a non-significant association with EBL-related bleeding risk (odds ratio, OR 1.07; 95% confidence interval 95% CI 1.00-1.16, p = 0.058). While serum bilirubin was a significant predictor for PRB (OR: 1.10; 95% CI 1.03-1.18), the presence of large varices (OR 0.85 vs. small varices; 95% CI 0.20-3.84), INR (OR 0.50; 95% CI 0.10-3.14), PLT (OR 1.00; 95% CI 1.00-1.01) and the use of non-selective betablockers (OR 1.20; CI 95% 0.38-3.76) were not associated with PRB. CONCLUSION: EBL is safe and procedure-related bleedings are rare (2.6%) including in patients with thrombocytopenia < 50 G/L or high INR ≥ 1.5. Only high MELD, and especially high bilirubin seem to be linked to an increased risk of EBL-related bleeding.
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Authors | Nikolaus Pfisterer, Michael Schwarz, Mathias Jachs, Florian Putre, Lukas Ritt, Mattias Mandorfer, Christian Madl, Michael Trauner, Thomas Reiberger |
Journal | Hepatology international
(Hepatol Int)
Vol. 17
Issue 5
Pg. 1205-1214
(Oct 2023)
ISSN: 1936-0541 [Electronic] United States |
PMID | 37024710
(Publication Type: Journal Article)
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Copyright | © 2023. The Author(s). |
Topics |
- Humans
- Esophageal and Gastric Varices
(complications)
- International Normalized Ratio
(adverse effects)
- Platelet Count
- Gastrointestinal Hemorrhage
(prevention & control)
- Ligation
(adverse effects, methods)
- Liver Cirrhosis
(complications)
- Thrombocytopenia
(complications)
- Varicose Veins
(complications)
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