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    Please use this identifier to cite or link to this item: https://tkuir.lib.tku.edu.tw/dspace/handle/987654321/118635


    Title: A Fourfold Increase of Oesophageal Variceal Bleeding in Cirrhotic Patients with a History of Oesophageal Variceal Bleeding
    Authors: Tsung-Hsing Hung;Chih-Wei Tseng;Chih-Chun Tsai;Chorng-Jang Lay;Chen-Chi Tsai
    Keywords: cirrhosis;epidemiology;oesophageal variceal bleeding;portal hypertension
    Date: 2016-01
    Issue Date: 2020-06-01 12:10:36 (UTC+8)
    Abstract: INTRODUCTION
    Large, recent population-based data for evaluating the predictors of oesophageal variceal bleeding (OVB) among cirrhotic patients is still lacking. This study aimed to determine the cumulative incidence of OVB among cirrhotic patients and identify the predictors of OVB occurrence.

    METHODS
    Patient information on 38,172 cirrhotic patients without a history of OVB, who were discharged between 1 January 2007 and 31 December 2007, was obtained from the Taiwan National Health Insurance Database for this study. All patients were followed up for three years. Death was the competing risk when calculating 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 hospitalisation. During the three-year follow-up period, the cumulative incidence of OVB was 44.5% and 11.3% in the OVB and non-OVB group, respectively (p < 0.001). Modified Cox 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 following the first incidence of OVB.
    Relation: Singapore Medical Journal 57(9), p.511-513
    DOI: 10.11622/smedj.2015177
    Appears in Collections:[Graduate Institute & Department of Computer Science and Information Engineering] Journal Article

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