Prognostic factors associated with mortality in patients with gastric fundal variceal bleeding

Keishi Komori, Masaru Kubokawa, Eikichi Ihara, Kazuya Akahoshi, Kazuhiko Nakamura, Kenta Motomura, Akihide Masumoto

研究成果: Contribution to journalArticle査読

8 被引用数 (Scopus)

抄録

AIM: To determine the prognostic factors associated with mortality in patients with gastric fundal variceal (GFV) bleeding. METHODS: In total, 42 patients were endoscopically diagnosed with GFV bleeding from January 2000 to March 2014. We retrospectively reviewed the patients' medical records and assessed their history, etiology of liver cirrhosis, disease conditions, treatment options for GFV bleeding, medications administered before and after onset of GFV bleeding, blood test results (hemoglobin, albumin, and bilirubin concentrations), and imaging results (including computed tomography and abdominal ultrasonography). We also assessed the prognostic factors associated with short-term mortality (up to 90 d) and long-term mortality in all patients. RESULTS: Multivariate analysis showed that prophylactic administration of antibiotics was an independent prognostic factor associated with decreases in short-term mortality (OR = 0.08, 95%CI: 0.01-0.52) and long-term mortality (OR = 0.27, 95%CI: 0.08-0.91) in patients with GFV bleeding. In contrast, concurrent hepatocellular carcinoma (HCC) and regular use of proton pump inhibitors (PPI) were independent prognostic factors associated with increases in short-term mortality (HCC: OR = 15.4, 95%CI: 2.08-114.75; PPI: OR = 12.76, 95%CI: 2.13-76.52) and long-term mortality (HCC: OR = 7.89, 95%CI: 1.98-31.58; PPI: OR = 10.91, 95%CI: 2.86-41.65) in patients with GFV bleeding. The long-term overall survival rate was significantly lower in patients who regularly used PPI than in those who did not use PPI (P = 0.0074). CONCLUSION: Administration of antibiotics is associated with decreased short- and long-term mortality, while concurrent HCC and regular PPI administration are associated with increased short- and long-term mortality.

本文言語英語
ページ(範囲)496-504
ページ数9
ジャーナルWorld Journal of Gastroenterology
23
3
DOI
出版ステータス出版済み - 1 21 2017

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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