دورية أكاديمية
أعرض في EDS

The magnitude and correlates of esophageal Varices among newly diagnosed cirrhotic patients undergoing screening fibre optic endoscope before incident bleeding in North-Western Tanzania; a cross-sectional study.

التفاصيل البيبلوغرافية
العنوان: The magnitude and correlates of esophageal Varices among newly diagnosed cirrhotic patients undergoing screening fibre optic endoscope before incident bleeding in North-Western Tanzania; a cross-sectional study.
المؤلفون: Gunda DW; Department of medicine, Weill Bugando School of Medicine, P.O Box 1464, Mwanza, Tanzania. daniel_rev2002@yahoo.com.; Department of medicine, Bugando medical center, 1370, Mwanza, Tanzania. daniel_rev2002@yahoo.com., Kilonzo SB; Department of medicine, Weill Bugando School of Medicine, P.O Box 1464, Mwanza, Tanzania.; Department of medicine, Bugando medical center, 1370, Mwanza, Tanzania., Mamballah Z; Department of medicine, Weill Bugando School of Medicine, P.O Box 1464, Mwanza, Tanzania., Manyiri PM; Department of medicine, Bugando medical center, 1370, Mwanza, Tanzania., Majinge DC; Department of medicine, Bugando medical center, 1370, Mwanza, Tanzania., Jaka H; Department of medicine, Bugando medical center, 1370, Mwanza, Tanzania.; Lake Zone Health Training institute, 11351, Bugando Mwanza, Tanzania., Kidenya BR; Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Mwanza, Tanzania., Mazigo HD; Department of Parasitology, Weill Bugando School of Medicine, 1464, Mwanza, Tanzania.
المصدر: BMC gastroenterology [BMC Gastroenterol] 2019 Nov 29; Vol. 19 (1), pp. 203. Date of Electronic Publication: 2019 Nov 29.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968547 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-230X (Electronic) Linking ISSN: 1471230X NLM ISO Abbreviation: BMC Gastroenterol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Endoscopy, Gastrointestinal*, Esophageal and Gastric Varices/*diagnosis , Liver Cirrhosis/*epidemiology, Adult ; Age Factors ; Ascites/epidemiology ; Cross-Sectional Studies ; Female ; Gastrointestinal Hemorrhage ; Humans ; Male ; Middle Aged ; Platelet Count ; Portal Vein/diagnostic imaging ; Sensitivity and Specificity ; Severity of Illness Index ; Spleen/diagnostic imaging ; Tanzania/epidemiology ; Ultrasonography
مستخلص: Background: Bleeding esophageal varices is a deadly complication of liver cirrhosis. Guidelines recommend an early diagnosis of esophageal varices before incident bleeding by screening all patients diagnosed with liver cirrhosis. Though it has been reported elsewhere that the presence of esophageal varices varies widely among cirrhotic patients this has not been assessed in Tanzania since endoscopy is not readily available for routine use in our setting. This study was designed to determine the prevalence of esophageal varices and assess the utility of clinical parameters in predicting the presence of varices among cirrhotic patients in northwestern Tanzania.
Methods: A cross-sectional analysis of adult patients with liver cirrhosis was done at Bugando Medical Centre. Demographic, clinical, laboratory and endoscopic data were collected and analyzed using STATA 13. The presence of esophageal varices was detected using endoscopic examination and associated factors were assessed by logistic regression. The predictive value of clinical predictors was also assessed by calculating sensitivity and specificity.
Results: A total of 223 patients were enrolled, where 88 (39.5%; 95%CI: 33.0-45.9) had esophageal varices. The varices were independently associated with increased age (OR: 1.02; 95%CI: 1.0-1.04; p = 0.030); increased splenic diameter (OR:1.3; 95%CI:1.2-1.5; p <  0.001), increased portal vein diameter (OR:1.2; 95%CI: 1.07-1.4; p = 0.003), having ascites (OR: 3.0; 95%CI: 1.01-8.7; p = 0.046), and advanced liver disease (OR: 2.9; 95%CI: 1.3-6.7; p = 0.008). PSDR least performed in predicting varices, (AUC: 0.382; 95%CI: 0.304-0.459; cutoff: < 640; Sensitivity: 58.0%; 95%CI: 46.9-68.4; specificity: 57.0%; 95%CI: 48.2-65.5). SPD had better prediction; (AUC: 0.713; 95%CI: 0.646-0.781; cut off: > 15.2 cm; sensitivity: 65.9%; (95% CI: 55-75.7 and specificity:65.2%; 95%CI: 56.5-73.2), followed by PVD, (AUC: 0.6392; 95%CI: 0.566-0.712;cutoff: > 1.45 cm; sensitivity: 62.5%; 95CI: 51.5-72.6; specificity: 61.5%; 95%CI: 52.7-69.7).
Conclusion: Esophageal varices were prevalent among cirrhotic patients, most of which were at risk of bleeding. The non-invasive prediction of varices was not strong enough to replace endoscopic diagnosis. However, the predictors in this study can potentially assist in the selection of patients at high risk of having varices and prioritize them for endoscopic screening and appropriate management.
References: Turk J Gastroenterol. 2017 Sep;28(5):347-352. (PMID: 28776495)
J Clin Gastroenterol. 2002 Jan;34(1):81-5. (PMID: 11743252)
Pan Afr Med J. 2015 Feb 17;20:145. (PMID: 27386022)
Arch Intern Med. 2001 Nov 26;161(21):2564-70. (PMID: 11718587)
BMC Gastroenterol. 2009 Feb 05;9:11. (PMID: 19196464)
Clin Liver Dis. 2001 Aug;5(3):645-63. (PMID: 11565135)
Gut. 2003 Aug;52(8):1200-5. (PMID: 12865282)
J Hepatol. 2004 May;40(5):823-30. (PMID: 15094231)
Saudi J Gastroenterol. 2011 Jan-Feb;17(1):64-8. (PMID: 21196656)
Hepatology. 2001 Feb;33(2):333-8. (PMID: 11172334)
BMC Gastroenterol. 2017 Dec 20;17(1):165. (PMID: 29262794)
J Gastroenterol Hepatol. 2007 Nov;22(11):1909-15. (PMID: 17914969)
Hepat Med. 2016 Apr 15;8:39-50. (PMID: 27186144)
Clin Gastroenterol Hepatol. 2007 Jul;5(7):803-8. (PMID: 17544879)
Hepatology. 2003 Sep;38(3):599-612. (PMID: 12939586)
Hepatology. 2007 Sep;46(3):922-38. (PMID: 17879356)
Gastrointest Endosc. 2000 Dec;52(6):707-14. (PMID: 11115900)
Dig Liver Dis. 2003 Jul;35(7):473-8. (PMID: 12870732)
Cochrane Database Syst Rev. 2017 Apr 26;4:CD008759. (PMID: 28444987)
Hepatology. 2003 Feb;37(2):366-77. (PMID: 12540787)
Gut. 2015 Nov;64(11):1680-704. (PMID: 25887380)
World J Gastroenterol. 2017 Jul 14;23(26):4806-4814. (PMID: 28765702)
J Hepatol. 2006 Jan;44(1):217-31. (PMID: 16298014)
Dig Dis Sci. 2012 Jun;57(6):1672-81. (PMID: 22367112)
N Engl J Med. 1991 May 30;324(22):1532-8. (PMID: 1674104)
Hepatology. 2004 Jan;39(1):204-10. (PMID: 14752839)
J Pediatr Gastroenterol Nutr. 2008 Feb;46(2):178-83. (PMID: 18223377)
J Hepatol. 2008;48 Suppl 1:S68-92. (PMID: 18304681)
Radiology. 1982 Apr;143(1):29-36. (PMID: 7063747)
J Gastroenterol Hepatol. 1999 Aug;14(8):785-90. (PMID: 10482429)
Hepatology. 2004 Jan;39(1):30-4. (PMID: 14752818)
JNMA J Nepal Med Assoc. 2017 Jul-Sep;56(207):298-303. (PMID: 29255309)
Am J Gastroenterol. 1999 Nov;94(11):3292-6. (PMID: 10566732)
World J Gastroenterol. 2014 Aug 14;20(30):10464-9. (PMID: 25132763)
Am J Gastroenterol. 2007 Sep;102(9):2086-102. (PMID: 17727436)
Gastroenterology. 1981 Apr;80(4):800-9. (PMID: 6970703)
Gastrointest Endosc. 2007 Jan;65(1):82-8. (PMID: 17185084)
Gastroenterol Rep (Oxf). 2016 Aug;4(3):186-95. (PMID: 27324725)
J Hepatol. 2003 Mar;38(3):266-72. (PMID: 12586291)
فهرسة مساهمة: Keywords: Esophageal varices; Liver cirrhosis; Non-invasive predictors; Northwestern Tanzania
تواريخ الأحداث: Date Created: 20191201 Date Completed: 20200420 Latest Revision: 20200420
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC6884911
DOI: 10.1186/s12876-019-1123-9
PMID: 31783802
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-230X
DOI:10.1186/s12876-019-1123-9