Child–Pugh Class and Not Thrombocytopenia Impacts the Risk of Complications of Endoscopic Band Ligation in Patients with Cirrhosis and High Risk Varices
Abstract
:1. Introduction
2. Patients and Methods
3. Statistical Analysis
4. Results
5. Discussion
Author Contributions
Funding
Data Availability Statement
Conflicts of Interest
Abbreviations
References
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Patients (Tot: 431) | |
---|---|
Age, y ± SD | 62.7 ± 12.7 |
Sex M, n (%) | 281 (65.2%) |
INR ± SD | 1.2 ± 0.3 |
Bilirubin mg/dL ± SD | 1.5 ± 1.5 |
Albumin g/dL ± SD | 3.3 ± 0.6 |
Creatinie mg/dL | 0.7 ± 0.6 |
Platelets/mm3 | 92,272 ± 83,320 |
Child–Pugh (median) | 6 |
A | 281 (65.2%) |
B | 134 (31.1%) |
C | 16 (3.7%) |
Etiology n (%) | |
Viral | 238 (55.2) |
- ASH | 40 (9.3) |
- NASH | 61 (14.2) |
- Autoimmune hepatitis | 15 (3.5) |
- ASH + viral | 7 (1.6) |
Other | 70 (16.2) |
Portal vein diameter, mm ± SD | 13.0 ± 0.85 |
Spleen LD, cm ± SD | 16.1 ± 0.7 |
- Liver events, n (%) | |
- Ascites n (%) | 183 (42.5) |
- Mild | 62 (14.4) |
- Moderate | 82 (19) |
- Severe | 39 (9) |
Pleural effusion n (%) | 22 (5) |
- HE n (%) | 27 (6.3) |
- Portal vein thrombosis n (%) | 72 (16.7) |
HCC n (%) | 73 (17) |
Antithrombotic therapy | 38 (8.8) |
Antiplatelets (ASA or cropidogrel) | 13 (3.0) |
LMWH | 19 (4.4) |
Warfarin | 6 (1.4) |
Esophageal Varices n (%) | |
---|---|
- F2 | 130 (30) |
- (F2 occ—dim, median) | 40–40 |
- F2 red marks | 48 (11) |
- (F2 red marks occ—dim, median) | 40–50 |
- F3 | 81 (18.8) |
- (F3 occ—dim, median) | 60–70 |
- F3 red marks | 172 (39.9) |
- (F3 red marks occ—dim, median) | 70–80 |
Gastric varices n (%) | 76 (17.6) |
Gov1 | 47 (10.9) |
Gov2 | 15 (3.5) |
Igv1 | 9 (2) |
Igv2 | 3 (0.7) |
Other GV | 5 (1.2) |
Complications | EBL Number (%) |
---|---|
Total | 86 (8.4) |
Intraprocedural bleeding | 41(4) |
Need for intervention | 6 (14.6) |
Hematocystic spots’ formation | 17 (1.7) |
Bleeding due to post-EBL ulcers | 6 (0.6) |
Esophageal ulcers | 11 (1.1) |
Strictures | 1 (0.1) |
Sepsis | 2 (0.2) |
Epigastralgia | 7 (0.7) |
Glottal edema | 1 (0.1) |
Intraprocedural Bleeding (41) | No Bleeding (987) | p Value | |
---|---|---|---|
EV n(%) | 0.5 | ||
F2 | 16 (39) | 389 (39.4) | |
F3 | 25 (61) | 598 (60.6) | |
PLT mean | 80,948.00 ± 37.658 | 87,837.00 ± 75.729 | 0.5 |
PLT ≥ 50,000 | 34 (83) | 825 (83.6) | |
PLT < 50,000 | 7 (17.0) | 162 (16.4) | 0.6 |
Bands N | 5.1 ± 1.3 | 5.2 ± 1.5 | 0.7 |
Antithrombotic drugs | 2 (4.9) | 36 (3.6) | 0.7 |
MELD | 8.3 ± 4.7 | 8.4 ± 3.4 | 0.8 |
CP | 6.8 ± 1.8 | 6.5 ± 1.5 | 0.3 |
Hematocystic Spots (17) | No Hematocystic Spots (1011) | p Value | |
---|---|---|---|
EV n (%) | 0.019 | ||
F2 | 12 (70) | 394 (39) | |
F3 | 5 (30) | 617 (61) | |
Mean PLT ± SD | 79,250.00 ± 44,713 | 87,170 ± 74,825 | 0.7 |
PLT < 50,000 | 5 (29.4%) | 164 (16.2%) | 0.3 |
N bands ± SD | 5.3 ± 1.1 | 5.2 ± 1.5 | 0.7 |
Antithrombotic drugs | 1 (5.9) | 37 (3.7) | 0.5 |
MELD ± SD | 8.4 ± 2.8 | 8.4 ± 3.5 | 0.9 |
CP ± SD | 6.8 ± 1.1 | 6.5 ± 1.3 | 0.5 |
Bleeding Due to Post-EBL Ulcers (6) | No Bleeding Due to Post-EBL Ulcers (1022) | p Value | |
---|---|---|---|
EV n (%) | 0.2 | ||
F2 | 4 (66.6) | 402 (39.3) | |
F3 | 2 (33.4) | 620 (60.7) | |
PLT mean ± SD | 125,666.00 ew ± 112,384 | 87,217 ± 74,011 | 0.4 |
PLT < 50.000 | 1 (16.7) | 168 (16.4) | 0.08 |
Bands N ± SD | 5.8 ± 1.6 | 5.2 ± 1.5 | 0.3 |
Antithrombotic drugs | 0 | 38 (3.7) | 0.9 |
MELD ± SD | 8.5 ± 3 | 8.4 ± 3.5 | 0.9 |
CP ± SD | 6.8 ± 1.6 | 6.5 ± 1.4 | 0.73 |
Cumulative Events (75) | No Events (953) | p Value | |
---|---|---|---|
EV n (%) | 0.2 | ||
F2 | 35 (46.7) | 372 (39) | |
F3 | 40 (53.3) | 581 (61) | |
PLT mean ± DS | 84,235 ± 54,175 | 77,804 ± 75,949 | 0.7 |
PLT < 50,000 pl | 17 (22.7%) | 152 (15.9%) | 0.4 |
Bands N. ± SD | 5.1 ± 1.6 | 5.2 ± 1.5 | 0.8 |
Antithrombotic drugs | 3 (4) | 35 (3.7) | 0.7 |
MELD ± SD | 8.5 ± 4.2 | 8.4 ± 3.4 | 0.9 |
CP ± SD | 6.9 ± 1.6 | 6.5 ± 1.3 | 0.043 |
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Di Martino, V.; Simone, F.; Grasso, M.; Abdel-Hadi, Y.; Peralta, M.; Veneziano, M.; Lombardo, A.; Peralta, S.; Calvaruso, V. Child–Pugh Class and Not Thrombocytopenia Impacts the Risk of Complications of Endoscopic Band Ligation in Patients with Cirrhosis and High Risk Varices. J. Pers. Med. 2023, 13, 764. https://doi.org/10.3390/jpm13050764
Di Martino V, Simone F, Grasso M, Abdel-Hadi Y, Peralta M, Veneziano M, Lombardo A, Peralta S, Calvaruso V. Child–Pugh Class and Not Thrombocytopenia Impacts the Risk of Complications of Endoscopic Band Ligation in Patients with Cirrhosis and High Risk Varices. Journal of Personalized Medicine. 2023; 13(5):764. https://doi.org/10.3390/jpm13050764
Chicago/Turabian StyleDi Martino, Vincenzo, Fabio Simone, Maria Grasso, Yasmin Abdel-Hadi, Marco Peralta, Marzia Veneziano, Antonino Lombardo, Sergio Peralta, and Vincenza Calvaruso. 2023. "Child–Pugh Class and Not Thrombocytopenia Impacts the Risk of Complications of Endoscopic Band Ligation in Patients with Cirrhosis and High Risk Varices" Journal of Personalized Medicine 13, no. 5: 764. https://doi.org/10.3390/jpm13050764