Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve?

Background. Current guidelines do not differentiate in the utilization of vasoactive drugs in patients with cirrhosis and acute variceal bleeding (AVB) depending on liver disease severity. Material and methods. In this retrospective study, clinical outcomes in 100 patients receiving octreotide plus...

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Autores principales: Monreal Robles, Roberto, Cortez Hernández, Carlos Alejandro, González González, José Alberto, Abraldes, Juan G., Bosques Padilla, Francisco Javier, Silva Ramos, Héctor Noé Guadalupe, García Flores, Jorge A., Maldonado Garza, Héctor Jesús
Formato: Artículo
Lenguaje:inglés
Publicado: 2018
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Acceso en línea:http://eprints.uanl.mx/20042/1/1-s2.0-S1665268119301164-main.pdf
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author Monreal Robles, Roberto
Cortez Hernández, Carlos Alejandro
González González, José Alberto
Abraldes, Juan G.
Bosques Padilla, Francisco Javier
Silva Ramos, Héctor Noé Guadalupe
García Flores, Jorge A.
Maldonado Garza, Héctor Jesús
author_facet Monreal Robles, Roberto
Cortez Hernández, Carlos Alejandro
González González, José Alberto
Abraldes, Juan G.
Bosques Padilla, Francisco Javier
Silva Ramos, Héctor Noé Guadalupe
García Flores, Jorge A.
Maldonado Garza, Héctor Jesús
author_sort Monreal Robles, Roberto
collection Repositorio Institucional
description Background. Current guidelines do not differentiate in the utilization of vasoactive drugs in patients with cirrhosis and acute variceal bleeding (AVB) depending on liver disease severity. Material and methods. In this retrospective study, clinical outcomes in 100 patients receiving octreotide plus endoscopic therapy (ET) and 216 patients with ET alone were compared in terms of failure to control bleeding, in-hospital mortality, and transfusion requirements stratifying the results according to liver disease severity by Child-Pugh (CP) score and MELD. Results. In patients with CP-A or those with MELD < 10 octreotide was not associated with a better outcome compared to ET alone in terms of hospital mortality (CP-A: 0.0 vs. 0.0%; MELD < 10: 0.0 vs. 2.9%, p = 1.00), failure to control bleeding (CP-A: 8.7 vs. 3.7%, p = 0.58; MELD < 10: 5.3 vs. 4.3%, p = 1.00) and need for transfusion (CP-A: 39.1 vs. 61.1%, p = 0.09; MELD < 10: 63.2 vs. 62.9%, p = 1.00). Those with severe liver dysfunction in the octreotide group showed better outcomes compared to the non-octreotide group in terms of hospital mortality (CP-B/C: 3.9 vs. 13.0%, p = 0.04; MELD
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spelling eprints-200422024-12-09T19:45:07Z http://eprints.uanl.mx/20042/ Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve? Monreal Robles, Roberto Cortez Hernández, Carlos Alejandro González González, José Alberto Abraldes, Juan G. Bosques Padilla, Francisco Javier Silva Ramos, Héctor Noé Guadalupe García Flores, Jorge A. Maldonado Garza, Héctor Jesús RC Medicina Interna, Psiquiatría, Neurología Background. Current guidelines do not differentiate in the utilization of vasoactive drugs in patients with cirrhosis and acute variceal bleeding (AVB) depending on liver disease severity. Material and methods. In this retrospective study, clinical outcomes in 100 patients receiving octreotide plus endoscopic therapy (ET) and 216 patients with ET alone were compared in terms of failure to control bleeding, in-hospital mortality, and transfusion requirements stratifying the results according to liver disease severity by Child-Pugh (CP) score and MELD. Results. In patients with CP-A or those with MELD < 10 octreotide was not associated with a better outcome compared to ET alone in terms of hospital mortality (CP-A: 0.0 vs. 0.0%; MELD < 10: 0.0 vs. 2.9%, p = 1.00), failure to control bleeding (CP-A: 8.7 vs. 3.7%, p = 0.58; MELD < 10: 5.3 vs. 4.3%, p = 1.00) and need for transfusion (CP-A: 39.1 vs. 61.1%, p = 0.09; MELD < 10: 63.2 vs. 62.9%, p = 1.00). Those with severe liver dysfunction in the octreotide group showed better outcomes compared to the non-octreotide group in terms of hospital mortality (CP-B/C: 3.9 vs. 13.0%, p = 0.04; MELD 2018 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/20042/1/1-s2.0-S1665268119301164-main.pdf http://eprints.uanl.mx/20042/1.haspreviewThumbnailVersion/1-s2.0-S1665268119301164-main.pdf Monreal Robles, Roberto y Cortez Hernández, Carlos Alejandro y González González, José Alberto y Abraldes, Juan G. y Bosques Padilla, Francisco Javier y Silva Ramos, Héctor Noé Guadalupe y García Flores, Jorge A. y Maldonado Garza, Héctor Jesús (2018) Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve? Annals of hepatology, 17 (1). pp. 125-133. ISSN 1665-2681 http://doi.org/10.5604/01.3001.0010.7544 doi:10.5604/01.3001.0010.7544
spellingShingle RC Medicina Interna, Psiquiatría, Neurología
Monreal Robles, Roberto
Cortez Hernández, Carlos Alejandro
González González, José Alberto
Abraldes, Juan G.
Bosques Padilla, Francisco Javier
Silva Ramos, Héctor Noé Guadalupe
García Flores, Jorge A.
Maldonado Garza, Héctor Jesús
Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve?
thumbnail https://rediab.uanl.mx/themes/sandal5/images/online.png
title Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve?
title_full Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve?
title_fullStr Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve?
title_full_unstemmed Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve?
title_short Acute Variceal Bleeding: Does Octreotide Improve Outcomes in Patients with Different Functional Hepatic Reserve?
title_sort acute variceal bleeding does octreotide improve outcomes in patients with different functional hepatic reserve
topic RC Medicina Interna, Psiquiatría, Neurología
url http://eprints.uanl.mx/20042/1/1-s2.0-S1665268119301164-main.pdf
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