Meta-analysis of risk factors of gastroesophageal varices rebleeding after therapeutic endoscopy

Abstract

To investigate the risk factors of gastroesophageal varices rebleeding after therapeutic endoscopy. Medline,EMBASE and the China Biology Medicine Database were searched for literature published between January 2000 to May 2013 on topics related to risk factors of gastroesophageal varices rebleeding after therapeutic endoscopy. Data from each study that meet the requirements for analysis were extracted and subjected to meta-analysis. Sixteen studies were collected for use in this meta-analysis. The odds ratio (OR) value of portal vein embolus was 7.88 (P<0.00001). The OR value of beta-blockers or nitrate medications was 0.53 (P=0.0008). The standardized mean difference (SMD) value of number of ligation points was 0.94 (P<0.01). The SMD value of albumin in the subgroup with follow-up time of less than or equal to 14 days was-0.89 (P<0.00001), while the SMD value of prothrombin time in the subgroup with follow-up time of less than or equal to 14 days was 1.78 (P<0.00001). Portal vein embolus, hepatocellular carcinoma, diameter of the portal vein, Child-Pugh classification C, moderate/excessive ascites, prothrombin time, and number of ligation points were risk factors of gastroesophageal varices early rebleeding after therapeutic endoscopy. Portal vein embolus, hepatocellular carcinoma, and diameter of the portal vein were risk factors of gastroesophageal varices long-term rebleeding after therapeutic endoscopy. Beta blockers or nitrate medications were protective factors of gastroesophageal varices rebleeding after therapeutic endoscopy.