Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding
Background: Acute variceal bleeding (AVB), a life-threatening complication of liver cirrhosis, can be effectively treated by endoscopy, but there is a risk of early rebleeding after endoscopic variceal treatment (EVT). Thrombocytopenia is the most common hemostatic abnormality in liver cirrhosis. Ho...
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SAGE Publishing
2025-01-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848241306934 |
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| author | Yan He Fernando Gomes Romeiro Mingyu Sun Fanpu Ji Qiang Zhu Yingli He Dapeng Ma Shanshan Yuan Xiaofeng Liu Cyriac Abby Philips Metin Basaranoglu Nahum Méndez-Sánchez Kanokwan Pinyopornpanish Yiling Li Yunhai Wu Ling Yang Lichun Shao Andrea Mancuso Yu Chen Frank Tacke Su Lin Lei Liu Bimin Li Xingshun Qi |
| author_facet | Yan He Fernando Gomes Romeiro Mingyu Sun Fanpu Ji Qiang Zhu Yingli He Dapeng Ma Shanshan Yuan Xiaofeng Liu Cyriac Abby Philips Metin Basaranoglu Nahum Méndez-Sánchez Kanokwan Pinyopornpanish Yiling Li Yunhai Wu Ling Yang Lichun Shao Andrea Mancuso Yu Chen Frank Tacke Su Lin Lei Liu Bimin Li Xingshun Qi |
| author_sort | Yan He |
| collection | DOAJ |
| description | Background: Acute variceal bleeding (AVB), a life-threatening complication of liver cirrhosis, can be effectively treated by endoscopy, but there is a risk of early rebleeding after endoscopic variceal treatment (EVT). Thrombocytopenia is the most common hemostatic abnormality in liver cirrhosis. However, it is still unclear about whether thrombocytopenia increases the failure of EVT in cirrhotic patients with AVB. Objectives: We investigated the association between thrombocytopenia and the failure of EVT in cirrhotic patients with AVB. Design: International multicenter, retrospective study. Methods: Overall, 2467 cirrhotic patients with acute gastrointestinal bleeding who were enrolled into an international multicenter study between September 30, 2020 and June 30, 2023 were retrospectively screened. Thrombocytopenia was defined as platelet count below 150 × 10 9 /L and further classified as mild (100 × 10 9 /L–150 × 10 9 /L), moderate (50 × 10 9 /L–100 × 10 9 /L), and severe (<50 × 10 9 /L). A 1:1 propensity score matching (PSM) analysis was performed. Five-day failure to control bleeding was evaluated. Results: Overall, 1079 patients were included, of whom 923 (85.5%) had thrombocytopenia, including mild ( n = 241), moderate ( n = 445), and severe ( n = 237) thrombocytopenia. PSM analysis demonstrated that the rate of 5-day failure to control bleeding was not significantly different between patients with and without thrombocytopenia (mild: (12/153) 7.8% vs (7/153) 4.6%, p = 0.236; moderate: (9/155) 5.8% vs (7/155) 4.5%, p = 0.608; or severe: (5/132) 3.8% vs (7/132) 5.3%, p = 0.555). Conclusion: Thrombocytopenia may not influence the efficacy of EVT in cirrhotic patients with AVB. |
| format | Article |
| id | doaj-art-f8e93ae5fde1493aa5d6203ffe390a44 |
| institution | Kabale University |
| issn | 1756-2848 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj-art-f8e93ae5fde1493aa5d6203ffe390a442025-01-04T13:03:25ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482025-01-011810.1177/17562848241306934Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleedingYan HeFernando Gomes RomeiroMingyu SunFanpu JiQiang ZhuYingli HeDapeng MaShanshan YuanXiaofeng LiuCyriac Abby PhilipsMetin BasaranogluNahum Méndez-SánchezKanokwan PinyopornpanishYiling LiYunhai WuLing YangLichun ShaoAndrea MancusoYu ChenFrank TackeSu LinLei LiuBimin LiXingshun QiBackground: Acute variceal bleeding (AVB), a life-threatening complication of liver cirrhosis, can be effectively treated by endoscopy, but there is a risk of early rebleeding after endoscopic variceal treatment (EVT). Thrombocytopenia is the most common hemostatic abnormality in liver cirrhosis. However, it is still unclear about whether thrombocytopenia increases the failure of EVT in cirrhotic patients with AVB. Objectives: We investigated the association between thrombocytopenia and the failure of EVT in cirrhotic patients with AVB. Design: International multicenter, retrospective study. Methods: Overall, 2467 cirrhotic patients with acute gastrointestinal bleeding who were enrolled into an international multicenter study between September 30, 2020 and June 30, 2023 were retrospectively screened. Thrombocytopenia was defined as platelet count below 150 × 10 9 /L and further classified as mild (100 × 10 9 /L–150 × 10 9 /L), moderate (50 × 10 9 /L–100 × 10 9 /L), and severe (<50 × 10 9 /L). A 1:1 propensity score matching (PSM) analysis was performed. Five-day failure to control bleeding was evaluated. Results: Overall, 1079 patients were included, of whom 923 (85.5%) had thrombocytopenia, including mild ( n = 241), moderate ( n = 445), and severe ( n = 237) thrombocytopenia. PSM analysis demonstrated that the rate of 5-day failure to control bleeding was not significantly different between patients with and without thrombocytopenia (mild: (12/153) 7.8% vs (7/153) 4.6%, p = 0.236; moderate: (9/155) 5.8% vs (7/155) 4.5%, p = 0.608; or severe: (5/132) 3.8% vs (7/132) 5.3%, p = 0.555). Conclusion: Thrombocytopenia may not influence the efficacy of EVT in cirrhotic patients with AVB.https://doi.org/10.1177/17562848241306934 |
| spellingShingle | Yan He Fernando Gomes Romeiro Mingyu Sun Fanpu Ji Qiang Zhu Yingli He Dapeng Ma Shanshan Yuan Xiaofeng Liu Cyriac Abby Philips Metin Basaranoglu Nahum Méndez-Sánchez Kanokwan Pinyopornpanish Yiling Li Yunhai Wu Ling Yang Lichun Shao Andrea Mancuso Yu Chen Frank Tacke Su Lin Lei Liu Bimin Li Xingshun Qi Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding Therapeutic Advances in Gastroenterology |
| title | Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding |
| title_full | Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding |
| title_fullStr | Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding |
| title_full_unstemmed | Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding |
| title_short | Impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding |
| title_sort | impact of thrombocytopenia on failure of endoscopic variceal treatment in cirrhotic patients with acute variceal bleeding |
| url | https://doi.org/10.1177/17562848241306934 |
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