Upper gastrointestinal hemorrhage in acute-on-chronic liver failure : prevalence, characteristics, and impact on prognosis
BACKGROUND: Upper gastrointestinal hemorrhage (UGH) is a life-threatening complication in patients with cirrhosis; however, data regarding the role of UGH in acute-on-chronic liver failure (ACLF) are limited.
METHODS: A prospective, observational cohort study was performed from February 2014 to Mach 2015.
RESULTS: UGH was identified in 170 of 492 cirrhotic patients with acute decompensation (AD) at the time of admission. Logistic regression analysis showed that fecal occult blood test positivity was an independent risk factor for UGH in patients with or without ACLF [OR(95%CI): 8.31(4.89-14.10), p < 0.001; and 6.29 (1.48-26.76), p = 0.031]. Other independent risk factors were a history of gastrointestinal bleeding [OR(95% CI): 13.43 (7.17-25.15), p < 0.001], older age [OR(95% CI): 0.98(0.96-0.99), p = 0.003], greater INR level [OR(95% CI): 0.48(0.28-0.81), p = 0.007] in patients without ACLF. Multivariate Cox proportional hazard model analysis indicated that UGH did not increase mortality at different times in cirrhotic patients with acute decompensation.
CONCLUSIONS: UGH is a frequent complication in cirrhotic patients with AD, even those with ACLF. Positive fecal occult blood tests and previous GI bleeding were shown to be associated with the risk of UGH. UGH did not significantly increase the risk of mortality in cirrhotic patients with AD or ACLF.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Expert review of gastroenterology & hepatology - 13(2019), 3 vom: 19. März, Seite 263-269 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhao, Hong [VerfasserIn] |
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| Links: |
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| Themen: |
Acute-on-chronic liver failure |
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| Anmerkungen: |
Date Completed 16.07.2019 Date Revised 16.07.2019 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/17474124.2019.1567329 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM294167773 |
|---|
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| 245 | 1 | 0 | |a Upper gastrointestinal hemorrhage in acute-on-chronic liver failure |b prevalence, characteristics, and impact on prognosis |
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| 500 | |a Date Completed 16.07.2019 | ||
| 500 | |a Date Revised 16.07.2019 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Upper gastrointestinal hemorrhage (UGH) is a life-threatening complication in patients with cirrhosis; however, data regarding the role of UGH in acute-on-chronic liver failure (ACLF) are limited | ||
| 520 | |a METHODS: A prospective, observational cohort study was performed from February 2014 to Mach 2015 | ||
| 520 | |a RESULTS: UGH was identified in 170 of 492 cirrhotic patients with acute decompensation (AD) at the time of admission. Logistic regression analysis showed that fecal occult blood test positivity was an independent risk factor for UGH in patients with or without ACLF [OR(95%CI): 8.31(4.89-14.10), p < 0.001; and 6.29 (1.48-26.76), p = 0.031]. Other independent risk factors were a history of gastrointestinal bleeding [OR(95% CI): 13.43 (7.17-25.15), p < 0.001], older age [OR(95% CI): 0.98(0.96-0.99), p = 0.003], greater INR level [OR(95% CI): 0.48(0.28-0.81), p = 0.007] in patients without ACLF. Multivariate Cox proportional hazard model analysis indicated that UGH did not increase mortality at different times in cirrhotic patients with acute decompensation | ||
| 520 | |a CONCLUSIONS: UGH is a frequent complication in cirrhotic patients with AD, even those with ACLF. Positive fecal occult blood tests and previous GI bleeding were shown to be associated with the risk of UGH. UGH did not significantly increase the risk of mortality in cirrhotic patients with AD or ACLF | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Liver cirrhosis | |
| 650 | 4 | |a acute-on-chronic liver failure | |
| 650 | 4 | |a gastrointestinal bleeding | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a upper gastrointestinal hemorrhage | |
| 700 | 1 | |a Zhao, Ruihong |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Jianhua |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xuan |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Jianke |e verfasserin |4 aut | |
| 700 | 1 | |a Shi, Yemin |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Weihang |e verfasserin |4 aut | |
| 700 | 1 | |a Sheng, Jifang |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Lanjuan |e verfasserin |4 aut | |
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