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| Name | Class |
|---|---|
| LanZhou University | OTHER |
| Beijing Shijitan Hospital, Capital Medical University | OTHER |
| Beijing 302 Hospital | OTHER |
| Tianjin Third Central Hospital |
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Cirrhotic patients with AVB across 34 university medical centers in 30 cities in China from February 2013 to May 2020 who underwent endoscopy within 24 hours were included in this study. Patients were divided into an urgent endoscopy group (endoscopy <6h after admission) and an early endoscopy group (endoscopy 6-24h after admission). Outcomes included the incidence of 5-day rebleeding, in-hospital mortality, need for intensive care unit (ICU) and the length of hospital stay after the endoscopy management. Multivariable analysis was performed to identify risk factors for rebleeding. A propensity score matching (PSM) analysis was performed to achieve a balance at baseline between the urgent and early groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| urgent endoscopy group | endoscopy <6h after admission |
| |
| early endoscopy group | endoscopy 6-24h after admission |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| emergency endoscopic therapy | Device | When cirrhotic patients presented with AVB to the emergency department, emergency physicians consulted gastroenterologists on duty to assess the patient for suitability for endoscopy, usually after initial stabilization. Performance of endoscopy and its timing was at the discretion of the gastroenterologist on call. Therapeutic endoscopy for AVB was performed within 24 hours after consultation by an experienced attending endoscopist, using standard forward-viewing upper gastrointestinal video endoscopes at individual centers. Written informed consent for endoscopy was obtained before each procedure. The standard of care at all hospitals was to administer a vasoactive agent and antibiotics upon the patient's presentation. Packed red blood cells were transfused at the discretion of the attending gastroenterologist. |
| Measure | Description | Time Frame |
|---|---|---|
| the incidence of 5-day rebleeding after emergency endoscopy | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| the in-hospital mortality | 6 months | |
| need for ICU | 6 months | |
| the length of hospital stay |
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Inclusion Criteria:
Exclusion Criteria:
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Complete demographic and clinical data of patients with cirrhosis associated with AVB who underwent emergency endoscopy within 24 hours between February 2013 and May 2020 across 34 university hospitals from 30 cities in China was retrospectively reviewed. Two independent investigators (Liu C and Huang Y) reviewed the medical records, including demographic, laboratory, clinical and endoscopic data.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The first hospital of Lanzhou university | Lanzhou | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29653741 | Background | European Association for the Study of the Liver. EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J Hepatol. 2018 Aug;69(2):406-460. doi: 10.1016/j.jhep.2018.03.024. Epub 2018 Apr 10. No abstract available. | |
| 32242355 | Background | Lau JYW, Yu Y, Tang RSY, Chan HCH, Yip HC, Chan SM, Luk SWY, Wong SH, Lau LHS, Lui RN, Chan TT, Mak JWY, Chan FKL, Sung JJY. Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding. N Engl J Med. 2020 Apr 2;382(14):1299-1308. doi: 10.1056/NEJMoa1912484. |
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| ID | Term |
|---|---|
| D008103 | Liver Cirrhosis |
| D006975 | Hypertension, Portal |
| ID | Term |
|---|---|
| D008107 | Liver Diseases |
| D004066 | Digestive System Diseases |
| D005355 | Fibrosis |
| D010335 | Pathologic Processes |
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| OTHER |
| Shenyang Sixth People's Hospital | OTHER |
| Shanxi Bethune Hospital | OTHER |
| Linyi People's Hospital | OTHER |
| Sir Run Run Shaw Hospital | OTHER |
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| 6 months |
| 22885718 | Background | Chen PH, Chen WC, Hou MC, Liu TT, Chang CJ, Liao WC, Su CW, Wang HM, Lin HC, Lee FY, Lee SD. Delayed endoscopy increases re-bleeding and mortality in patients with hematemesis and active esophageal variceal bleeding: a cohort study. J Hepatol. 2012 Dec;57(6):1207-13. doi: 10.1016/j.jhep.2012.07.038. Epub 2012 Aug 8. |
| D013568 |
| Pathological Conditions, Signs and Symptoms |