Tratamiento endoscópico y combinado con octreotide en hemorragia por várices esofágicas. Beneficio según la gravedad al ingreso / [Endoscopic versus endoscopic plus octreotide treatment for acute variceal bleeding. Benefit according to severity at admission].

ABSTRACT

UNLABELLED Vasoactive agents plus endoscopic treatment was recommended in esophageal variceal bleeding (EVB). However, the use according to severity on admission has been poorly evaluated OBJECTIVES: To evaluate the efficacy of endoscopic versus endoscopic plus octreotide treatment in patients with EVB according to severity on admission. METHODS: Between June 2001 and December 2011, 247 patients with EVB were treated using endoscopic or combined endoscopic plus octreotide treatment. Patients were analyzed according to the following cohorts all patients, those with and without active bleeding, and by Child classes. Initial hemostatic failure, in-hospital rebleeding and in-hospital mortality were compared with both treatments. RESULTS: All patients with combined treatment had less initial hemostatic failure (P = 0.0157) and rebleeding (P = 0.0011) when compared to endoscopic treatment. Active bleeding patients and Child C patients had a significant reduction of initial hemostatic failure when receiving combined treatment vs endoscopic treatment (P = 0.0479 and P = 0.0222, respectively). Child C patients and patients without active bleeding significantly decreased rebleeding with combined treatment (P = 0.0139 and P = 0.0056, respectively). Global mortality was 17