Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 03 May 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Comparison of scoring systems for patients with severe variceal bleeding

A study in the most recent Alimentary Pharmacology & Therapeutics compares scoring systems and outcomes of patients admitted to a liver intensive care unit of a tertiary referral centre with severe variceal bleeding.

News image

Acute variceal hemorrhage is associated with significant mortality.

Professor Julia Wendon and colleagues from the United Kingdom determined outcome and factors associated with hospital mortality in patients with acute variceal hemorrhage admitted to intensive care unit (ICU).

The team compared outcomes of patients requiring transfer to a tertiary ICU to a local in-patient group.

A retrospective study of all adult patients admitted to ICU with acute variceal hemorrhage from 2000–2008 was performed.

Median age was 48 years, and males represented 58%.

The team found that the median MELD score was 16, and SOFA score was 8.

HM was higher in patients who had severe liver disease or critical illness measured by MELD, SOFA, APACHE II scores and number of failed organs.

The researchers found that patients with day-1 lactate ≥ 2 mmol/L had increased hospital mortality.
Patients requiring transfer had less severe liver disease
Alimentary Pharmacology & Therapeutics

The team observed that MELD score performed as well as APACHE II, SOFA and number of failed organs in predicting hospital mortality.

Re-bleeding was associated with increased hospital mortality.

The team noted that the patients requiring transfer had less severe liver disease and critical illness, and consequently had lower hospital mortality than local patients.

Transferred patients with ≥2 endoscopies prior to transfer had increased 6-week mortality.

The researchers found that time from bleeding to transfer ≥3 days was associated with re-bleeding.

Professor Wendon's team concludes, "MELD score was comparable to ICU prognostic models in predicting mortality."

"Blood lactate was also predictive of hospital mortality."

"Delays in referrals and repeated endoscopy were associated with increased re-bleeding and mortality in this group."

Aliment Pharmacol Ther 2014: 39(11): 1286–1300
16 May 2014

Go to top of page Email this page Email this page to a colleague

 03 May 2016 
PPIs and gut microbiota
 03 May 2016 
Vedolizumab for IBD
 03 May 2016 
Surgery vs medical therapy for GERD
 02 May 2016 
Mycophenolate mofetil as first-line treatment of autoimmune hepatitis
 02 May 2016 
Genetic variant that increase NAFLD risk
 02 May 2016 
Resection of colorectal polyps
 29 April 2016 
HCV infection in Baby Boomers with Medicare
 29 April 2016 
Simvastatins and survival in cirrhosis
 29 April 2016 
Crohn's disease associated genes
 28 April 2016 
Diarrheal diseases in children
 28 April 2016 
Birth outcomes in women with IBD receiving assisted reproduction
 28 April 2016 
Racial disparities in survival from colon cancer
 27 April 2016 
Celiac disease in adults
 27 April 2016 
Ultra-short celiac disease
 27 April 2016 
Dust mite and human GI tract
 26 April 2016 
Guidelines for nutrition therapy in hospitalized patients
 26 April 2016 
Polyp detection during colonoscopy
 26 April 2016 
IBS and microscopic colitis
 25 April 2016 
Estrogen deficiency and fibrosis risk in women with NAFLD
 25 April 2016 
Acceptance of Liver transplant center organ offers
 25 April 2016 
Abrupt interruption of beta-blockers in cirrhosis 
 22 April 2016 
Novel method to regenerate the esophagus
 22 April 2016 
Relapse after antiviral treatment in Hep B
 22 April 2016 
Microscopic colitis with NSAIDs and PPIs
 11 April 2016 
Infliximab vs adalimumab in ulcerative colitis
 11 April 2016 
H. pylori in treatment-naïve children
 11 April 2016 
Admissions times and outcomes for ERCP cholangitis
 08 April 2016 
Endoscopic treatment of Crohn's strictures
 08 April 2016 
Nutrition therapy in the hospitalized patient
 08 April 2016 
H.pylori effects on pediatric gastric mucosa
 07 April 2016 
CVD changes after TIPSS
 07 April 2016 
Transanal mesorectal resection for rectal cancer
 07 April 2016 
HBV during immunosuppressive therapies
 06 April 2016 
Adherence to colorectal cancer screening strategies
 06 April 2016 
Duodenal bulb biopsies in childhood celiac disease diagnosis
 06 April 2016 
Lymph node metastasis in early gastric cancer
 05 April 2016 
IBS in the US military
 05 April 2016 
Changes in blood flow in cirrhosis
 05 April 2016 
Colorectal cancer risk with serrated polyps
 04 April 2016 
Noninvasive diagnosis of celiac disease
 04 April 2016 
Metallic vs plastic stents for benign biliary strictures
 04 April 2016 
Adherence to quality indicators improves clinical outcomes in ascites
 01 April 2016 
Prognosis after colorectal cancer resection with peritoneal metastasis
 01 April 2016 
Colorectal cancer risk with non-malignant colonoscopy findings
 01 April 2016 
Intensive enteral nutrition and severe alcoholic hepatitis
 31 March 2016 
Anesthesia services during colonoscopy
 31 March 2016 
Management of Barrett’s esophagus
 31 March 2016 
Alcohol and glucose tolerance in NAFLD
 30 March 2016 
Depression and symptoms in IBS
 30 March 2016 
Electronic learning system for colon capsule endoscopy
 30 March 2016 
Gastric cancer screening
 29 March 2016 
Statins and survival in esophageal cancer
 29 March 2016 
Infant feeding practices and celiac disease
 25 March 2016 
Medical therapy and neoplasia regression in familial adenomatous polyposis
 25 March 2016 
Medical therapy compliance and ulcerative colitis recurrence
 25 March 2016 
Predicting outcomes of drug-induced acute liver failure
 24 March 2016 
Thrombocytopenia and multi-organ system failure in acute liver failure
 24 March 2016 
Patients with ulcerative colitis and their concerns
 24 March 2016 
Prediction of relapses in IBD
 23 March 2016 
Thiopurine therapy in IBD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us