Data_Sheet_1_Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study.pdf (242.06 kB)
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Data_Sheet_1_Treatment Strategies in Emergency Endoscopy for Acute Esophageal Variceal Bleeding (CHESS1905): A Nationwide Cohort Study.pdf

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posted on 27.04.2022, 04:56 by Yifei Huang, Wenhui Zhang, Huiling Xiang, Yanna Liu, Lili Yuan, Liyao Zhang, Shengjuan Hu, Dongli Xia, Jia Li, Min Gao, Xing Wang, Xingsi Qi, Lijun Peng, Ying Song, Xiqiao Zhou, Jing Zeng, Xiaoyan Tan, Mingming Deng, Haiming Fang, Shenglin Qi, Song He, Yongfeng He, Bin Ye, Wei Wu, Tong Dang, Jiangbo Shao, Wei Wei, Jianping Hu, Xin Yong, Chaohui He, Jinlun Bao, Yuening Zhang, Guo Zhang, Rui Ji, Yang Bo, Wei Yan, Hongjiang Li, Yanling Wang, Mengmeng Li, Fengmei Wang, Jia Lian, Chang’en Liu, Ping Cao, Zhenbei Liu, Aimin Liu, Lili Zhao, Shuang Li, Yunhai Wu, Ye Gu, Yan Wang, Yanfei Fang, Pan Jiang, Bin Wu, Chuan Liu, Xiaolong Qi
Background and Aims

Emergency endoscopy is recommended for patients with acute esophageal variceal bleeding (EVB) and their prognosis has improved markedly over past decades due to the increased specialization of endoscopic practice. The study aimed to compare outcomes following emergency endoscopic injection sclerotherapy (EIS) and endoscopic variceal ligation (EVL) in cirrhotic patients with acute EVB.

Methods

Cirrhotic patients with acute EVB who underwent emergency endoscopy were retrospectively enrolled from 2013 to 2020 across 34 university hospitals from 30 cities. The primary outcome was the incidence of 5-day rebleeding after emergency endoscopy. Subgroup analysis was stratified by Child-Pugh class and bleeding history. A 1:1 propensity score matching (PSM) analysis was performed.

Results

A total of 1,017 and 382 patients were included in EIS group and EVL group, respectively. The 5-day rebleeding incidence was similar between EIS group and EVL group (4% vs. 5%, P = 0.45). The result remained the same after PSM (P = 1.00). Among Child-Pugh class A, B and C patients, there were no differences in the 5-day rebleeding incidence between the two groups after PSM (P = 0.25, 0.82, and 0.21, respectively). As for the patients with or without bleeding history, the differences between EIS group and EVL group were not significant after PSM (P = 1.00 and 0.26, respectively).

Conclusion

The nationwide cohort study indicates that EIS and EVL are both efficient emergency endoscopic treatment strategies for acute EVB. EIS should not be dismissed as an economical and effective emergency endoscopic treatment strategy of acute EVB. ClincialTrials.gov number NCT04307264.

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