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    Title: A Fourfold Increase of Oesophageal Variceal Bleeding in Cirrhotic Patients with a History of Oesophageal Variceal Bleeding
    Authors: Hung, T. H.;Tseng, C. W.;Tsai, C. C.;Lay, C. J.;Tsai, C. C.
    Keywords: cirrhosis;epidemiology;oesophageal variceal bleeding;portal hypertension
    Date: 2015/11/25
    Issue Date: 2016-04-22 13:11:19 (UTC+8)
    Abstract: INTRODUCTION:
    There is no large, recent, population-based data for evaluating the predictors of oesophageal variceal bleeding (OVB) among cirrhotic patients. The aim of this study was to determine the cumulative incidence of OVB among cirrhotic patients and to identify the predictors of OVB occurrence.
    METHODS:
    The patient information of 38,172 cirrhotic patients without OVB history who were discharged between 1 January and 31 December 2007 was obtained from the Taiwan National Health Insurance Database for use in this study. All patients were followed up for three years. Death was considered as the competing risk in the calculations of the cumulative incidences and hazard ratios (HRs) of OVB.
    RESULTS:
    OVB was present in 2,609 patients (OVB group) and absent in 35,563 patients (non-OVB group) at the time of hospitalisation. During the three-year follow-up period, the cumulative incidence of OVB was 44.5% in the OVB group, while it was 11.3% in the non-OVB group (p < 0.001). Modified Cox's regression analysis showed that the HR of OVB history was 4.42 for OVB occurrence (95% confidence interval [CI] 4.13-4.74). Other predictors for OVB occurrence included hepatocellular carcinoma (HR 1.16, 95% CI 1.09-1.24), young age (HR 0.98, 95% CI 0.98-0.98), ascites (HR 1.46, 95% CI 1.37-1.56), alcohol-related disorders (HR 1.20, 95% CI 1.12-1.28), peptic ulcer bleeding (HR 1.26, 95% CI 1.13-1.41) and diabetes mellitus (HR 1.14, 95% CI 1.06-1.23).
    CONCLUSION:
    Cirrhotic patients have a fourfold increased risk of future OVB once they suffered from their first OVB.
    Relation: Singapore Medical Journal 2015, pp.1-10
    DOI: 10.11622/smedj.2015177
    Appears in Collections:[數學學系暨研究所] 期刊論文

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