The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Outcomes of patients treated with Sengstaken-Blakemore tube for uncontrolled variceal hemorrhage

  • Choi, Ja Yun (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Jo, Yun Won (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Lee, Sang Soo (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Kim, Wan Soo (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Oh, Hye Won (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Kim, Cha Young (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Yun, Eun Young (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Kim, Jin Joo (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Lee, Jae Min (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Kim, Hong Jun (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Kim, Hyun Jin (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Kim, Tae Hyo (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Jung, Woon Tae (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Lee, Ok Jae (Department of Internal Medicine, Gyeongsang National University Hospital) ;
  • Kim, Rock Bum (Regional Cardiocerebrovascular Disease Center, Gyeongsang National University School of Medicine)
  • Received : 2016.10.25
  • Accepted : 2017.02.08
  • Published : 2018.07.01
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Abstract

Background/Aims: The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment. Methods: The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed. Results: The overall success rate of initial hemostasis with SB tube was 75.8%, and the independent factors associated with hemostasis were non-intubated state before SB tube (odds ratio, 8.50; p = 0.007) and Child-Pugh score < 11 (odds ratio, 15.65; p = 0.022). Rebleeding rate after successful initial hemostasis with SB tube was 22.0%, and esophageal rupture occurred in 6.1%. Mortality within 30 days was 42.4%, and the related independent factors with mortality were failure of initial hemostasis with SB tube (hazard ratio, 6.24; p < 0.001) and endotracheal intubation before SB tube (hazard ratio, 2.81; p = 0.018). Conclusions: Since the era of endoscopic band ligation, SB tube might be a beneficial option as a temporary salvage treatment for uncontrolled variceal hemorrhage. However, rescue therapy had a high incidence of fatal complication and rebleeding.

Keywords

References

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