Esophageal Varices Screening of Cirrhotic Patients in Samutsakhon Hospital
Keywords:
esophageal varices (ev), esophageal variceal ligation (evl), gastric varices, gastric variceal treatment (glue injection)Abstract
Objective: This was to study the prevalence of esophageal varices and to find risk factors of esohageal varice occurences in cirrhotic patients at Samutsakhon Hospital.
Methods: A prospective cohort study was conducted from information data sheets and esophagogastroduodenal endoscopic reports of cirrhotic patients at GI clinic between 25 October and 31 March 2023. Analysis of the data was done using mean, median, SD, range, 95% CI, and odds ratio.
Result: Total 96 cirrhotic patients at GI clinic had median age of 57 ± 12 years, male more than female (60.4 vs. 39.6%). The most underlying disease of patients was hypertension (29.2%). The most common cause of cirrhosis was found in hepatitis B infection (35.4%).
A half of cirrhotic patients was found presenting with esophageal varices (50%). Grading of esophageal varices classified to F1, F2, and F3. Of these patients, 47.9%, 17.7%, and 1% had F1, F2, and F3 respectively. Also, 6.3% of patients were found gastric varices.
Conclusions: A half of patients was found EV and male was a risk factor for esophageal varices with significant statistical analysis (p-value < .01). In addition, 22.9% of patients with cirrhosis caused by alcohol use when gastroscopy were found more than other causes with significantly statistical analysis (p-value < .01).
References
Mittal S, Kanwal F, Ying J, et al. Effectiveness of surveillance for hepatocellular carcinoma in clinical practice: a United States cohort. J Hepatol 2016;65(6):1148–54. doi: 10.1016/j.jhep.2016.07.025.
Tapper EB, Asrani SK. The COVID-19 pandemic will have a long-lasting impact on the quality of cirrhosis care. J Hepatol 2020;73(2):441–5. doi: 10.1016/j.jhep.2020.04.005.
Kanwal F, Kramer J, Asch MS, et al. An Explicit quality indicator set for measurement of quality of care in patients with cirrhosis. Clin Gastroenterol Hepatol 2010;8(8):709–17. doi: 10.1016/j.cgh.2010.03.028.
Asrani SK, Devarbhavi H, Eaton J, et al. Burden of liver diseases in the world. J Hepatol 2019;70(1):151–71. doi: 10.1016/j.jhep.2018.09.014.
Ratib S, Fleming KM, Crooks CJ, et al. 1 and 5 year survival estimates for people with cirrhosis of the liver in England, 1998–2009: a large population study. J Hepatol 2014;60(2):282–9. doi: 10.1016/j.jhep.2013.09.027.
Yeo YH, Hwang J, Jeong D, et al. Surveillance of patients with cirrhosis remains suboptimal in the United States. J Hepatol. 2021;75(4):856–64. doi: 10.1016/j.jhep.2021.04.042.
Maurice JB, Brodkin E, Arnold F, et al. Validation of the Baveno VI criteria to identify low risk cirrhotic patients not requiring endoscopic surveillance for varices. J Hepatol 2016;65(5):899–905. doi: 10.1016/j.jhep.2016.06.021.
De Franchis R. Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: stratifying risk and individualizing care for portal hypertension. J Hepatol 2015;63(3):743–52. doi: 10.1016/j.jhep.2015.05.022.
Jacobson IM, Lim JK, Fried MW. American Gastroenterological Association Institute clinical practice update-expert review: care of patients who have achieved a sustained virologic response after antiviral therapy for chronic hepatitis C infection. Gastroenterology 2017;152(6):1578–87. doi: 10.1053/j.gastro.2017.03.018.
D’Amico G, Garcia-Tsao G, Pagliaro L. Natural history and prognostic indicators of survival in cirrhosis: a systemic review of 118 studies. J Hepatol 2006;44(1):217–31. doi: 10.1016/j.jhep.2005.10.013.
Groszmann RJ, Garcia-Tsao G, Bosch J, et al. Beta-blockers to prevent gastroesophageal varices in patients with cirrhosis. N Engl J Med 2005;353(21):2254–61. doi: 10.1056/NEJMoa044456.
Merli M, Nicolini G, Angeloni S, et al. Incidence and natural history of small esophageal varices in cirrhotic patients. J Hepatol 2008;38(3):266–72. doi: 10.1016/s0168-8278(02)00420-8.
European Association for the Study of the Liver. EASL clnical practice guidelines for the management of patients with decompensated cirrhosis. J Hepatol 2018;69(2)403–60. doi: 10.1016/j.jhep.2018.03.024.
Madhotra R, Hugh ME, Ira W, et al. Prediction of esophageal varices in patients with cirrhosis. J Clin Gastroenterol 2002;34(1):81–5. doi: 10.1097/00004836-200201000-00016.
Silva MJ, Bernardes C, Pinto J, et al. Baveno VI recommendation on avoidance of screening endoscopy in cirrhotic patients: Are we there yet?. Port J Gastroenterol 2017;24(2):79–83. doi: 10.1159/000452693.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
