PMID- 28210086
OWN - NLM
STAT- MEDLINE
DCOM- 20170717
LR  - 20181113
IS  - 2219-2840 (Electronic)
IS  - 1007-9327 (Print)
IS  - 1007-9327 (Linking)
VI  - 23
IP  - 3
DP  - 2017 Jan 21
TI  - Prognostic factors associated with mortality in patients with gastric fundal 
      variceal bleeding.
PG  - 496-504
LID - 10.3748/wjg.v23.i3.496 [doi]
AB  - AIM: To determine the prognostic factors associated with mortality in patients 
      with gastric fundal variceal (GFV) bleeding. METHODS: In total, 42 patients were 
      endoscopically diagnosed with GFV bleeding from January 2000 to March 2014. We 
      retrospectively reviewed the patients' medical records and assessed their 
      history, etiology of liver cirrhosis, disease conditions, treatment options for 
      GFV bleeding, medications administered before and after onset of GFV bleeding, 
      blood test results (hemoglobin, albumin, and bilirubin concentrations), and 
      imaging results (including computed tomography and abdominal ultrasonography). We 
      also assessed the prognostic factors associated with short-term mortality (up to 
      90 d) and long-term mortality in all patients. RESULTS: Multivariate analysis 
      showed that prophylactic administration of antibiotics was an independent 
      prognostic factor associated with decreases in short-term mortality (OR = 0.08, 
      95%CI: 0.01-0.52) and long-term mortality (OR = 0.27, 95%CI: 0.08-0.91) in 
      patients with GFV bleeding. In contrast, concurrent hepatocellular carcinoma 
      (HCC) and regular use of proton pump inhibitors (PPI) were independent prognostic 
      factors associated with increases in short-term mortality (HCC: OR = 15.4, 95%CI: 
      2.08-114.75; PPI: OR = 12.76, 95%CI: 2.13-76.52) and long-term mortality (HCC: OR 
      = 7.89, 95%CI: 1.98-31.58; PPI: OR = 10.91, 95%CI: 2.86-41.65) in patients with 
      GFV bleeding. The long-term overall survival rate was significantly lower in 
      patients who regularly used PPI than in those who did not use PPI (P = 0.0074). 
      CONCLUSION: Administration of antibiotics is associated with decreased short- and 
      long-term mortality, while concurrent HCC and regular PPI administration are 
      associated with increased short- and long-term mortality.
FAU - Komori, Keishi
AU  - Komori K
AD  - Keishi Komori, Masaru Kubokawa, Kazuya Akahoshi, Department of Gastroenterology, 
      Aso Iizuka Hospital, Iizuka 820-8505, Japan.
FAU - Kubokawa, Masaru
AU  - Kubokawa M
AD  - Keishi Komori, Masaru Kubokawa, Kazuya Akahoshi, Department of Gastroenterology, 
      Aso Iizuka Hospital, Iizuka 820-8505, Japan.
FAU - Ihara, Eikichi
AU  - Ihara E
AD  - Keishi Komori, Masaru Kubokawa, Kazuya Akahoshi, Department of Gastroenterology, 
      Aso Iizuka Hospital, Iizuka 820-8505, Japan.
FAU - Akahoshi, Kazuya
AU  - Akahoshi K
AD  - Keishi Komori, Masaru Kubokawa, Kazuya Akahoshi, Department of Gastroenterology, 
      Aso Iizuka Hospital, Iizuka 820-8505, Japan.
FAU - Nakamura, Kazuhiko
AU  - Nakamura K
AD  - Keishi Komori, Masaru Kubokawa, Kazuya Akahoshi, Department of Gastroenterology, 
      Aso Iizuka Hospital, Iizuka 820-8505, Japan.
FAU - Motomura, Kenta
AU  - Motomura K
AD  - Keishi Komori, Masaru Kubokawa, Kazuya Akahoshi, Department of Gastroenterology, 
      Aso Iizuka Hospital, Iizuka 820-8505, Japan.
FAU - Masumoto, Akihide
AU  - Masumoto A
AD  - Keishi Komori, Masaru Kubokawa, Kazuya Akahoshi, Department of Gastroenterology, 
      Aso Iizuka Hospital, Iizuka 820-8505, Japan.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Gastroenterol
JT  - World journal of gastroenterology
JID - 100883448
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Antibiotic Prophylaxis
MH  - Bacterial Infections/*drug therapy
MH  - Carcinoma, Hepatocellular/*complications
MH  - Esophageal and Gastric Varices/*complications/mortality
MH  - Female
MH  - Gastric Fundus/pathology
MH  - Gastrointestinal Hemorrhage/blood/drug therapy/etiology/*mortality
MH  - Humans
MH  - Liver Cirrhosis/*complications
MH  - Liver Neoplasms/*complications
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Proton Pump Inhibitors/administration & dosage/*adverse effects/therapeutic use
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Tomography, X-Ray Computed
MH  - Ultrasonography
PMC - PMC5291855
OTO - NOTNLM
OT  - Antibiotics
OT  - Gastric fundus
OT  - Gastric varices
OT  - Hemorrhage
OT  - Proton pump inhibitors
COIS- Conflict-of-interest statement: The authors declare no conflict of interest.
EDAT- 2017/02/18 06:00
MHDA- 2017/07/18 06:00
PMCR- 2017/01/21
CRDT- 2017/02/18 06:00
PHST- 2016/09/23 00:00 [received]
PHST- 2016/12/13 00:00 [revised]
PHST- 2016/12/21 00:00 [accepted]
PHST- 2017/02/18 06:00 [entrez]
PHST- 2017/02/18 06:00 [pubmed]
PHST- 2017/07/18 06:00 [medline]
PHST- 2017/01/21 00:00 [pmc-release]
AID - 10.3748/wjg.v23.i3.496 [doi]
PST - ppublish
SO  - World J Gastroenterol. 2017 Jan 21;23(3):496-504. doi: 10.3748/wjg.v23.i3.496.