|
- 现金
- 222032 元
- 精华
- 285
- 帖子
- 67620
- 注册时间
- 2001-11-10
- 最后登录
- 2023-5-7
|
1楼
发表于 2001-11-28 20:50
Risk Factors for the Presence of Varices in Cirrhotic Patients Without a
History of Variceal Hemorrhage
Atif Zaman, MD, MPH; Thomas Becker, MD, PhD; Jodi Lapidus, PhD; Kent
Benner, MD
Background Current medical management dictates that all cirrhotic patients without a history of variceal hemorrhage undergo endoscopic screening to detect large varices. However, referral for endoscopic screening of only patients at highest risk for varices may be most cost-effective. The aim of this case-control study was to identify clinical, laboratory, and radiologic findings that predict the presence of varices in patients with cirrhosis.
Methods Three hundred patients without a history of variceal hemorrhage underwent upper endoscopy as part of an evaluation before liver transplantation. Cases defined as the presence of any varices and cases defined as the presence of large varices were used for examining the risks associated with finding varices on upper endoscopy. Logistic regression was performed to evaluate associations between the presence of varices and patient characteristics.
Results Platelet count and Child-Pugh class were independent risk factors for the presence of any varices and the presence of large varices. For the presence of any varices, a platelet count of 90 103/µL or less (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.4-4.0) and advanced Child-Pugh class (OR, 3.0; 95% CI, 1.6-5.6) were independent risk factors. For large varices, a platelet count of 80 103/µL or less (OR, 2.3; 95% CI, 1.4-3.9) and advanced Child-Pugh class (OR, 2.8; 95% CI, 1.3-5.8) were independent risk factors associated with varices.
Conclusions Low platelet count and advanced Child-Pugh class were
associated with the presence of any varices and with large varices. These factors allow identification of a subgroup of cirrhotic patients who would benefit most from referral for endoscopic screening for varices.
Arch Intern Med. 2001;161:2564-2570
|
|
