Predicting early rebleeding and mortality after endoscopic hemostasis of esophagogastric varices: Diagnostic performance of aspartate aminotransferase-to-platelet ratio index and model for end-stage liver disease-Na score.

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-07-18 DOI:10.1002/jhbp.12057
Shinya Yokoyama, Takashi Honda, Yoji Ishizu, Norihiro Imai, Takanori Ito, Kenta Yamamoto, Kazuyuki Mizuno, Masanao Nakamura, Hiroki Kawashima
{"title":"Predicting early rebleeding and mortality after endoscopic hemostasis of esophagogastric varices: Diagnostic performance of aspartate aminotransferase-to-platelet ratio index and model for end-stage liver disease-Na score.","authors":"Shinya Yokoyama, Takashi Honda, Yoji Ishizu, Norihiro Imai, Takanori Ito, Kenta Yamamoto, Kazuyuki Mizuno, Masanao Nakamura, Hiroki Kawashima","doi":"10.1002/jhbp.12057","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Endoscopic variceal ligation and sclerotherapy are recommended for esophagogastric variceal bleeding (EGVB) in cirrhosis but can be complicated by early rebleeding and death. This study aimed to identify noninvasive markers accurately predicting early rebleeding and mortality after endoscopic hemostasis for EGVB.</p><p><strong>Methods: </strong>Among 116 patients with endoscopically confirmed EGVB and endoscopic hemostasis, various noninvasive markers were calculated, and their predictive accuracy was compared by receiver-operating characteristic curve analysis. Endpoints included 5-day rebleeding, 5-day mortality, 6-week rebleeding, and 6-week mortality.</p><p><strong>Results: </strong>The median age was 63 years. Child-Pugh class B and C patients accounted for 40.5% and 34.5%, respectively. Only the aspartate aminotransferase-to-platelet ratio index (APRI) significantly predicted 5-day rebleeding, with an area under the curve (AUC) of 0.777 (95% confidence interval [CI]: 0.537-1). The model for end-stage liver disease-Na (MELD-Na) score showed good predictive accuracy for 5-day mortality (AUC: 0.839, 95% CI: 0.681-0.997), 6-week rebleeding (AUC: 0.797, 95% CI: 0.663-0.932), and 6-week mortality (AUC: 0.888, 95% CI: 0.797-0.979).</p><p><strong>Conclusions: </strong>Patients with cirrhosis with a high APRI and MELD-Na score were at high risk of early rebleeding and death after EGVB. Allocating appropriate monitoring and care for those patients is necessary.</p>","PeriodicalId":16056,"journal":{"name":"Journal of Hepato‐Biliary‐Pancreatic Sciences","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hepato‐Biliary‐Pancreatic Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jhbp.12057","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Endoscopic variceal ligation and sclerotherapy are recommended for esophagogastric variceal bleeding (EGVB) in cirrhosis but can be complicated by early rebleeding and death. This study aimed to identify noninvasive markers accurately predicting early rebleeding and mortality after endoscopic hemostasis for EGVB.

Methods: Among 116 patients with endoscopically confirmed EGVB and endoscopic hemostasis, various noninvasive markers were calculated, and their predictive accuracy was compared by receiver-operating characteristic curve analysis. Endpoints included 5-day rebleeding, 5-day mortality, 6-week rebleeding, and 6-week mortality.

Results: The median age was 63 years. Child-Pugh class B and C patients accounted for 40.5% and 34.5%, respectively. Only the aspartate aminotransferase-to-platelet ratio index (APRI) significantly predicted 5-day rebleeding, with an area under the curve (AUC) of 0.777 (95% confidence interval [CI]: 0.537-1). The model for end-stage liver disease-Na (MELD-Na) score showed good predictive accuracy for 5-day mortality (AUC: 0.839, 95% CI: 0.681-0.997), 6-week rebleeding (AUC: 0.797, 95% CI: 0.663-0.932), and 6-week mortality (AUC: 0.888, 95% CI: 0.797-0.979).

Conclusions: Patients with cirrhosis with a high APRI and MELD-Na score were at high risk of early rebleeding and death after EGVB. Allocating appropriate monitoring and care for those patients is necessary.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
预测食管胃静脉曲张内镜止血后的早期再出血和死亡率:天冬氨酸氨基转移酶与血小板比率指数和终末期肝病-Na评分模型的诊断性能。
背景:肝硬化食管胃底静脉曲张出血(EGVB)推荐采用内镜下静脉曲张结扎和硬化治疗,但可能会因早期再出血和死亡而变得复杂。本研究旨在确定能准确预测内镜下止血治疗 EGVB 后早期再出血和死亡率的无创标记物:方法:在116例经内镜确诊为EGVB并行内镜止血的患者中,计算了各种无创标记物,并通过接收器-操作特征曲线分析比较了它们的预测准确性。终点包括 5 天再出血、5 天死亡率、6 周再出血和 6 周死亡率:中位年龄为 63 岁。Child-Pugh分级B级和C级患者分别占40.5%和34.5%。只有天冬氨酸氨基转移酶与血小板比值指数(APRI)能显著预测5天再出血,其曲线下面积(AUC)为0.777(95% 置信区间[CI]:0.537-1)。终末期肝病-Na(MELD-Na)评分模型对5天死亡率(AUC:0.839,95% CI:0.681-0.997)、6周再出血(AUC:0.797,95% CI:0.663-0.932)和6周死亡率(AUC:0.888,95% CI:0.797-0.979)显示出良好的预测准确性:结论:APRI和MELD-Na评分较高的肝硬化患者在EGVB术后早期再出血和死亡的风险较高。有必要对这些患者进行适当的监测和护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
期刊最新文献
Minimally invasive approach of hepatectomy and thrombectomy for hepatocellular carcinoma with right atrial tumor thrombus without sternotomy using percutaneous cardiopulmonary bypass. Prognostic significance of creatine kinase in resected pancreatic cancer. Short- and long-term outcomes of liver resection with hepatic vein reconstruction for liver tumors: A nationwide multicenter survey. Issue Information Frailty as a predictor of adverse outcomes in patients with hepatectomy - the importance of design studies to improve frailty: A systematic review and meta-analysis of 128 868 patients.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1