Analysis of the treatment outcomes of esophageal variceal bleeding patients from multiple centers in China

Abstract

This study aimed to investigate the treatment outcomes of esophageal variceal bleeding (EVB) in China. A total of 1087 cases were collected from 19 hospitals in 16 large and medium sized cities across China between January 1st, 2005 and January 1st, 2006. There were 313 cases (29.0%) of mild ( 1500 mL) bleeding. Successful hemostasis was achieved in 89.8% of cases. Seven hundred and eighty-five cases were treated by medication with a hemostasis rate of 91.8%. Seventy-one cases were treated using a Sengstaken-Blakemore tube with a hemostasis rate of 54.9%. Thirty-seven cases were treated with emergency endoscopic variceal ligation with a hemostasis rate of 83.8%. Seventy-seven cases were treated with endoscopic sclerotherapy with a hemostasis rate of 94.8%. Forty-three cases were treated with emergency surgical operation with a hemostasis rate of 95.3%. Sixty-six cases were treated with combined therapy with a hemostasis rate of 97.0%. There was a significant difference (P < 0.01) in the successful hemostasis rate between different treatments. The overall mortality was 10.1%, among which 6.6% was directly caused by bleeding. The multivariate logistic regression analysis shows that the severity of bleeding, treatment methods, liver dysfunction and activation of hepatitis were predictive factors for successful hemostasis. Most cases of EVB were mild and moderate in severity. The first-line treatment for EVB is medication. Emergency endoscopic intervention has not been widely available yet. The overall management outcome of EVB has been improved.