Abstract | BACKGROUND: METHODS: From January 2006 to December 2009, 46 patients diagnosed with upper GI bleeding caused by angiodysplasia or GAVE at a tertiary hospital were recruited into this study. They included 26 males and 20 females with an average age of 65.6 years (range, 45-90 years). All patients underwent APC for hemostasis during an endoscopic procedure. Parameters such as underlying co-morbidities, number of endoscopic treatment sessions, recurrent bleeding, and clinical outcomes during follow-up were analyzed. RESULTS: The 46 patients with UGI vascular ectasia hemorrhage included 27 patients with angiodysplasia and 19 with GAVE. The patients with angiodysplasia were older than those with GAVE (71.6 ± 10.2 years versus 61.8 ± 11.9 years, P = 0.005). More GAVE patients than angiodysplasia patients had co-existing liver cirrhosis (63.2% versus 25.9%, P = 0.012). The patients with GAVE had a higher rate of recurrent bleeding (78.9% versus 7.4%, P < 0.001) and required more treatment sessions to achieve complete hemostasis (2.4 ± 1.4 versus 1.1 ± 0.1, P < 0.001) than those with angiodysplasia. Univariate analysis demonstrated that age greater than 60 years (odds ratio (OR) = 8.929, P = 0.003), GAVE (OR = 0.021, P < 0.001), and previous radiation therapy (OR = 11.667, P = 0.032) were associated with higher rates of recurrent bleeding. Further multivariate analysis revealed that GAVE was the only independent risk factor for recurrent bleeding after APC treatment (OR = 0.027, P < 0.001). CONCLUSION:
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Authors | Yi-Chun Chiu, Lung-Sheng Lu, Keng-Liang Wu, William Tam, Ming-Luen Hu, Wei-Chen Tai, King-Wah Chiu, Seng-Kee Chuah |
Journal | BMC gastroenterology
(BMC Gastroenterol)
Vol. 12
Pg. 67
(Jun 09 2012)
ISSN: 1471-230X [Electronic] England |
PMID | 22681987
(Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Aged
- Aged, 80 and over
- Angiodysplasia
(complications, surgery)
- Argon Plasma Coagulation
(adverse effects, methods)
- Endoscopy, Gastrointestinal
(adverse effects, methods)
- Female
- Follow-Up Studies
- Gastric Antral Vascular Ectasia
(complications, surgery)
- Gastrointestinal Hemorrhage
(etiology, mortality, surgery)
- Hemostasis, Endoscopic
(adverse effects, methods)
- Humans
- Male
- Middle Aged
- Multivariate Analysis
- Recurrence
- Retrospective Studies
- Risk Factors
- Survival Rate
- Treatment Outcome
- Upper Gastrointestinal Tract
(blood supply)
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