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A prospective study of the ability of three endoscopic classifications to predict hemorrhage from esophageal varices.
- Source :
-
Gastrointestinal endoscopy [Gastrointest Endosc] 1992 Jul-Aug; Vol. 38 (4), pp. 425-9. - Publication Year :
- 1992
-
Abstract
- Hemorrhage from esophageal varices in cirrhotics is a frequent event with high mortality in spite of therapy. Preventive sclerotherapy seems to be beneficial only if the patient's bleeding risk is higher than 40 to 50% a year. A series of 320 patients with esophageal varices without previous bleeding was studied prospectively; the varices were classified according to three widely used endoscopic classifications. During follow-up (6 to 36 months, average 14 months), hemorrhage occurred in 49 patients (15.3%) of whom 30 (61.2%) bled from varices (8.2 and 11.0% at 12 and 24 months, respectively). At the same time intervals, mortality of the entire population studied was 18.0 and 23.8%, respectively, of which one third was directly due to hemorrhage. With all three classifications, the higher the degree of bleeding risk, the greater the actual percentage of hemorrhages recorded; however, it never reached 40% a year. In predicting the bleeding event, Dagradi's classification proved more sensitive than JRSPH or NIEC, but the latter classifications were more specific and assessed a higher predictive value for a positive test. Endoscopic observation probably needs integration with other methods if a reliable bleeding prediction is to be made.
- Subjects :
- Esophageal and Gastric Varices classification
Esophageal and Gastric Varices diagnosis
Female
Follow-Up Studies
Humans
Incidence
Life Tables
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Risk Factors
Sensitivity and Specificity
Time Factors
Esophageal and Gastric Varices epidemiology
Esophagoscopy
Gastrointestinal Hemorrhage epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 0016-5107
- Volume :
- 38
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Gastrointestinal endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 1511815
- Full Text :
- https://doi.org/10.1016/s0016-5107(92)70470-2