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2016 ; 28
(11
): 1275-9
Nephropedia Template TP
gab.com Text
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No difference in mortality between terlipressin and somatostatin treatments in
cirrhotic patients with esophageal variceal bleeding and renal functional
impairment
#MMPMID27455080
Hung TH
; Tsai CC
; Tseng CW
; Tseng KC
; Hsieh YH
; Tsai CC
Eur J Gastroenterol Hepatol
2016[Nov]; 28
(11
): 1275-9
PMID27455080
show ga
OBJECTIVE: To study the differences in mortality between terlipressin and
somatostatin treatments in cirrhotic patients with esophageal variceal bleeding
(EVB) and renal functional impairment (RFI). METHODS: The National Health
Insurance Database, part of the Taiwan National Health Insurance Program, was
used to enroll cirrhotic patients who had received endoscopic variceal ligation
plus somatostatin or terlipressin for EVB and who were hospitalized between 1
January 2007 and 31 December 2010. The differences in mortality between the two
vasoactive agents were compared and the risk factors for 30-day mortality because
of EVB were identified. RESULTS: A total of 2324 cirrhotic patients with EVB were
enrolled. The 30-day mortality data showed no significant differences between the
somatostatin and the terlipressin groups (P=0.232). The risk of 30-day mortality
was significantly higher in male patients [hazard ratio (HR): 1.50, P=0.002] and
patients with hepatic encephalopathy (HR: 1.82, P<0.001), ascites (HR: 1.32,
P=0.008), bacterial infections (HR: 2.10, P<0.001), hepatocellular carcinoma (HR:
2.09, P<0.001), and RFI (HR: 3.89, P<0.001). A subgroup analysis of cirrhotic
patients with RFI was carried out. The overall 30-day mortality was higher in
patients treated with somatostatin than in those treated with terlipressin (52.6
vs. 42.3%), but the difference failed to reach significance (adjust HR: 1.49, 95%
confidence interval: 0.94-2.37, P=0.091). CONCLUSION: RFI was the most important
risk factor for 30-day mortality in EVB patients. Terlipressin and somatostatin
had similar effects on 30-day mortality in cirrhotic patients with EVB and RFI.
|Adult
[MESH]
|Aged
[MESH]
|Databases, Factual
[MESH]
|Esophageal and Gastric Varices/*drug therapy/etiology/mortality
[MESH]