Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3122
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Background & Aim: We analysed prognostic indicators of long-term outcome in cirrhotic patients surviving the critical 6-week period after an episode of acute variceal bleeding.
Methods: All patients with oesophageal variceal bleeding from 2001-2007 were prospectively registered. Follow-up extended from day 42 after index bleeding to last visit, death or liver transplantation (LT). Multivariate Cox regression analysis was performed.
Results: Two hundred and fifty variceal bleeding episodes were registered. Fifty-four patients (26%) died before day 42, and 123 patients were finally included. Median follow-up was 23.5 months. Nadolol+/-nitrates alone or combined with variceal ligation were used as prophylaxis in 93% of patients. During follow-up, 43 patients (35%) experienced rebleeding, 34 (27.5%) died and 10 (8%) were transplanted. Follow-up beta-blocker dose (HR 0.993, 95% CI 0.987-0.998, P=0.027) and alcohol abstinence (HR 0.324, 95% CI 0.152-0.691, P=0.004) were independent rebleeding predictors. The Cox analysis disclosed the Child-Pugh score (HR 1.24, 95% CI 1.08-1.43, P=0.002), creatinine (HR 1.82, 95% CI 1.17-2.82, P=0.008), beta-blocker dose (HR 0.992, 95% CI 0.987-0.997, P=0.003), viral cirrhosis (HR 2.72, 95% CI 1.31-5.67, P=0.008), hepatocellular carcinoma (HR 9.44, 95% CI 3.54-25.20, P<0.001) and alcohol abstinence (HR 0.29, 95% CI 0.13-0.62, P=0.002) to be independent prognostic markers for mortality/LT.
Conclusion: High doses of beta-blockers and alcohol abstinence decrease rebleeding and mortality in cirrhotic patients surviving the 6-week period after acute variceal bleeding.
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Source |
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http://dx.doi.org/10.1111/j.1478-3231.2010.02287.x | DOI Listing |
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