Yan He, Fernando Gomes Romeiro, Mingyu Sun, Fanpu Ji, Qiang Zhu, Yingli He, Dapeng Ma, Shanshan Yuan, Xiaofeng Liu, Cyriac Abby Philips, Metin Basaranoglu, Nahum Méndez-Sánchez, Kanokwan Pinyopornpanish, Yiling Li, Yunhai Wu, Ling Yang, Lichun Shao, Andrea Mancuso, Yu Chen, Frank Tacke, Su Lin, Lei Liu, Bimin Li, Xingshun Qi
{"title":"血小板减少对肝硬化急性静脉曲张出血患者内镜下静脉曲张治疗失败的影响。","authors":"Yan He, Fernando Gomes Romeiro, Mingyu Sun, Fanpu Ji, Qiang Zhu, Yingli He, Dapeng Ma, Shanshan Yuan, Xiaofeng Liu, Cyriac Abby Philips, Metin Basaranoglu, Nahum Méndez-Sánchez, Kanokwan Pinyopornpanish, Yiling Li, Yunhai Wu, Ling Yang, Lichun Shao, Andrea Mancuso, Yu Chen, Frank Tacke, Su Lin, Lei Liu, Bimin Li, Xingshun Qi","doi":"10.1177/17562848241306934","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute variceal bleeding (AVB), a life-threatening complication of liver cirrhosis, can be effectively treated by endoscopy, but there is a risk of early rebleeding after endoscopic variceal treatment (EVT). Thrombocytopenia is the most common hemostatic abnormality in liver cirrhosis. However, it is still unclear about whether thrombocytopenia increases the failure of EVT in cirrhotic patients with AVB.</p><p><strong>Objectives: </strong>We investigated the association between thrombocytopenia and the failure of EVT in cirrhotic patients with AVB.</p><p><strong>Design: </strong>International multicenter, retrospective study.</p><p><strong>Methods: </strong>Overall, 2467 cirrhotic patients with acute gastrointestinal bleeding who were enrolled into an international multicenter study between September 30, 2020 and June 30, 2023 were retrospectively screened. Thrombocytopenia was defined as platelet count below 150 × 10<sup>9</sup>/L and further classified as mild (100 × 10<sup>9</sup>/L-150 × 10<sup>9</sup>/L), moderate (50 × 10<sup>9</sup>/L-100 × 10<sup>9</sup>/L), and severe (<50 × 10<sup>9</sup>/L). A 1:1 propensity score matching (PSM) analysis was performed. Five-day failure to control bleeding was evaluated.</p><p><strong>Results: </strong>Overall, 1079 patients were included, of whom 923 (85.5%) had thrombocytopenia, including mild (<i>n</i> = 241), moderate (<i>n</i> = 445), and severe (<i>n</i> = 237) thrombocytopenia. PSM analysis demonstrated that the rate of 5-day failure to control bleeding was not significantly different between patients with and without thrombocytopenia (mild: (12/153) 7.8% vs (7/153) 4.6%, <i>p</i> = 0.236; moderate: (9/155) 5.8% vs (7/155) 4.5%, <i>p</i> = 0.608; or severe: (5/132) 3.8% vs (7/132) 5.3%, <i>p</i> = 0.555).</p><p><strong>Conclusion: </strong>Thrombocytopenia may not influence the efficacy of EVT in cirrhotic patients with AVB.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848241306934"},"PeriodicalIF":3.9000,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700413/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding.\",\"authors\":\"Yan He, Fernando Gomes Romeiro, Mingyu Sun, Fanpu Ji, Qiang Zhu, Yingli He, Dapeng Ma, Shanshan Yuan, Xiaofeng Liu, Cyriac Abby Philips, Metin Basaranoglu, Nahum Méndez-Sánchez, Kanokwan Pinyopornpanish, Yiling Li, Yunhai Wu, Ling Yang, Lichun Shao, Andrea Mancuso, Yu Chen, Frank Tacke, Su Lin, Lei Liu, Bimin Li, Xingshun Qi\",\"doi\":\"10.1177/17562848241306934\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Acute variceal bleeding (AVB), a life-threatening complication of liver cirrhosis, can be effectively treated by endoscopy, but there is a risk of early rebleeding after endoscopic variceal treatment (EVT). Thrombocytopenia is the most common hemostatic abnormality in liver cirrhosis. However, it is still unclear about whether thrombocytopenia increases the failure of EVT in cirrhotic patients with AVB.</p><p><strong>Objectives: </strong>We investigated the association between thrombocytopenia and the failure of EVT in cirrhotic patients with AVB.</p><p><strong>Design: </strong>International multicenter, retrospective study.</p><p><strong>Methods: </strong>Overall, 2467 cirrhotic patients with acute gastrointestinal bleeding who were enrolled into an international multicenter study between September 30, 2020 and June 30, 2023 were retrospectively screened. Thrombocytopenia was defined as platelet count below 150 × 10<sup>9</sup>/L and further classified as mild (100 × 10<sup>9</sup>/L-150 × 10<sup>9</sup>/L), moderate (50 × 10<sup>9</sup>/L-100 × 10<sup>9</sup>/L), and severe (<50 × 10<sup>9</sup>/L). A 1:1 propensity score matching (PSM) analysis was performed. Five-day failure to control bleeding was evaluated.</p><p><strong>Results: </strong>Overall, 1079 patients were included, of whom 923 (85.5%) had thrombocytopenia, including mild (<i>n</i> = 241), moderate (<i>n</i> = 445), and severe (<i>n</i> = 237) thrombocytopenia. PSM analysis demonstrated that the rate of 5-day failure to control bleeding was not significantly different between patients with and without thrombocytopenia (mild: (12/153) 7.8% vs (7/153) 4.6%, <i>p</i> = 0.236; moderate: (9/155) 5.8% vs (7/155) 4.5%, <i>p</i> = 0.608; or severe: (5/132) 3.8% vs (7/132) 5.3%, <i>p</i> = 0.555).</p><p><strong>Conclusion: </strong>Thrombocytopenia may not influence the efficacy of EVT in cirrhotic patients with AVB.</p>\",\"PeriodicalId\":48770,\"journal\":{\"name\":\"Therapeutic Advances in Gastroenterology\",\"volume\":\"18 \",\"pages\":\"17562848241306934\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-01-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700413/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Gastroenterology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17562848241306934\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17562848241306934","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding.
Background: Acute variceal bleeding (AVB), a life-threatening complication of liver cirrhosis, can be effectively treated by endoscopy, but there is a risk of early rebleeding after endoscopic variceal treatment (EVT). Thrombocytopenia is the most common hemostatic abnormality in liver cirrhosis. However, it is still unclear about whether thrombocytopenia increases the failure of EVT in cirrhotic patients with AVB.
Objectives: We investigated the association between thrombocytopenia and the failure of EVT in cirrhotic patients with AVB.
Design: International multicenter, retrospective study.
Methods: Overall, 2467 cirrhotic patients with acute gastrointestinal bleeding who were enrolled into an international multicenter study between September 30, 2020 and June 30, 2023 were retrospectively screened. Thrombocytopenia was defined as platelet count below 150 × 109/L and further classified as mild (100 × 109/L-150 × 109/L), moderate (50 × 109/L-100 × 109/L), and severe (<50 × 109/L). A 1:1 propensity score matching (PSM) analysis was performed. Five-day failure to control bleeding was evaluated.
Results: Overall, 1079 patients were included, of whom 923 (85.5%) had thrombocytopenia, including mild (n = 241), moderate (n = 445), and severe (n = 237) thrombocytopenia. PSM analysis demonstrated that the rate of 5-day failure to control bleeding was not significantly different between patients with and without thrombocytopenia (mild: (12/153) 7.8% vs (7/153) 4.6%, p = 0.236; moderate: (9/155) 5.8% vs (7/155) 4.5%, p = 0.608; or severe: (5/132) 3.8% vs (7/132) 5.3%, p = 0.555).
Conclusion: Thrombocytopenia may not influence the efficacy of EVT in cirrhotic patients with AVB.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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