Endoscopic screening for varices in cirrhotic patients: data from a national endoscopic database - PubMed (original) (raw)
Endoscopic screening for varices in cirrhotic patients: data from a national endoscopic database
Mary Kovalak et al. Gastrointest Endosc. 2007 Jan.
Abstract
Background: The current guidelines for primary prophylaxis of variceal hemorrhage in cirrhotic patients recommend screening for varices with upper endoscopy (EGD). Utilization and outcomes of screening in clinical practice are unknown.
Objective: Our purpose was to determine the use of endoscopic variceal screening in diverse practice settings and to determine factors associated with the finding of esophageal varices.
Design: Endoscopic reports generated by the Clinical Outcomes Research Initiative (CORI) repository were analyzed to determine the use, changes over time, and findings of screening upper endoscopies between January 1, 2000, and December 31, 2003.
Setting: Data from 68 CORI practices (70% community/17% academic/13% Veterans Affairs Medical Center [VAMC]) were evaluated.
Patients: A total of 1688 of 172,854 EGDs were performed for the purpose of screening for varices.
Results: Overall, there was a linear increase in annual proportion of screening EGDs performed (P < .0001). A significantly greater proportion of variceal screening EGDs are performed in academic centers compared with VAMC and community practices. Varices were found in 881 screened patients (52.2%). Varices were found more often in Child-Pugh class B/C (71.9%) compared with Child-Pugh class A (42.7%) patients. Of those with varices found, patients with Child-Pugh class B/C were more likely to have large varices than were patients with Child-Pugh class A (P = .02).
Limitations: A limitation of this study was the inability to determine the total number of cirrhotic patients cared for at each CORI site included in this study.
Conclusions: Endoscopic screening for varices represents a small proportion of all upper endoscopies performed. This proportion increased between 2000 and 2003. Varices were found more frequently in patients with more severe liver disease.
Similar articles
- An evaluation of endoscopic indications and findings related to nonvariceal upper-GI hemorrhage in a large multicenter consortium.
Enestvedt BK, Gralnek IM, Mattek N, Lieberman DA, Eisen G. Enestvedt BK, et al. Gastrointest Endosc. 2008 Mar;67(3):422-9. doi: 10.1016/j.gie.2007.09.024. Epub 2008 Jan 18. Gastrointest Endosc. 2008. PMID: 18206878 - Factors predicting the presence of esophageal or gastric varices in patients with advanced liver disease.
Zaman A, Hapke R, Flora K, Rosen HR, Benner K. Zaman A, et al. Am J Gastroenterol. 1999 Nov;94(11):3292-6. doi: 10.1111/j.1572-0241.1999.01540.x. Am J Gastroenterol. 1999. PMID: 10566732 - Endoscopic screening for esophageal varices in cirrhosis: Is it ever cost effective?
Spiegel BM, Targownik L, Dulai GS, Karsan HA, Gralnek IM. Spiegel BM, et al. Hepatology. 2003 Feb;37(2):366-77. doi: 10.1053/jhep.2003.50050. Hepatology. 2003. PMID: 12540787 - Endoscopic screening for varices in cirrhosis: findings, implications, and outcomes.
Jensen DM. Jensen DM. Gastroenterology. 2002 May;122(6):1620-30. doi: 10.1053/gast.2002.33419. Gastroenterology. 2002. PMID: 12016427 Review. - Non-invasive (and minimally invasive) diagnosis of oesophageal varices.
de Franchis R. de Franchis R. J Hepatol. 2008 Oct;49(4):520-7. doi: 10.1016/j.jhep.2008.07.009. Epub 2008 Jul 26. J Hepatol. 2008. PMID: 18706733 Review.
Cited by
- Cystatin C/albumin ratio for early diagnosis of esophageal varices in liver cirrhosis.
Cheng H, Zhu Y. Cheng H, et al. Medicine (Baltimore). 2024 Jun 28;103(26):e38481. doi: 10.1097/MD.0000000000038481. Medicine (Baltimore). 2024. PMID: 38941375 Free PMC article. - Correlation between diameter of esophageal varices and early rebleeding following endoscopic variceal ligation: a multicenter retrospective study based on artificial intelligence-based endoscopic virtual rule.
Cao C, Jin J, Cai R, Chu Y, Wu K, Wang Z, Xiao T, Zhang H, Huang H, Liu H, Zhang Q, Mei X, Kong D. Cao C, et al. Front Med (Lausanne). 2024 Jun 12;11:1406108. doi: 10.3389/fmed.2024.1406108. eCollection 2024. Front Med (Lausanne). 2024. PMID: 38933116 Free PMC article. - Magnetic resonance elastography (MRE) outperforms acoustic force radiation impulse (ARFI) in predicting oesophageal varices in obese NAFLD cirrhosis.
Roy A, Verma N, Jajodia S, Goenka U, Tiwari A, Sonthalia N, Goenka M. Roy A, et al. Abdom Radiol (NY). 2024 Sep;49(9):3088-3095. doi: 10.1007/s00261-024-04309-5. Epub 2024 Apr 23. Abdom Radiol (NY). 2024. PMID: 38652124 - Improved Applicability and Diagnostic Accuracy of the Novel Spleen-Dedicated Transient Elastography Device for High-Risk Esophageal Varices.
Madir A, Barisic Jaman M, Milosevic M, Dinjar Kujundžić P, Grgurevic I. Madir A, et al. Diagnostics (Basel). 2024 Mar 30;14(7):743. doi: 10.3390/diagnostics14070743. Diagnostics (Basel). 2024. PMID: 38611656 Free PMC article. - Accuracy of non-invasive diagnosis of esophageal varices among cirrhotic patients in a low-income setting.
Gebregziabiher HT, Hailu W, Abay Z, Bizuneh S, Meshesha MD. Gebregziabiher HT, et al. Heliyon. 2023 Dec 3;9(12):e23229. doi: 10.1016/j.heliyon.2023.e23229. eCollection 2023 Dec. Heliyon. 2023. PMID: 38149190 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical