Management of digestive bleeding related to portal hypertension in cirrhotic patients: A French multicenter cross-sectional practice survey

Table 1 Main characteristics of the patients

Characteristics	n = 126
Age (yr, median and range)	56 (32 to 83)
Sex (M/F)	103/23
Causes of cirrhosis [n (%)]
- Alcoholism	101 (80%)
- Hepatitis virus (B, C)	11 (9%)
- Alcoholism plus another cause	4 (3%)
- Other causes	5 (4%)
- Unknown	5 (4%)
Child-Pugh class A/B/C (n)1	27/42/53

¹Missing data: two incomplete files and two early deaths.

Table 2 Previous bleeding and prophylaxis given before the index bleeding

Prophylaxis	n (%)
First bleeding event1	79 (63)
- Cirrhosis known before admission	40/79
- Prior endoscopy	25/40
- Prophylaxis before admission:	16/25
Esophageal varices stage 0-1:	0/7
Esophageal varices stage 2-3:	16/18
• Beta-blockade	12
• Ligation	2
• Ligation and beta-blockade	2
Recurrent bleeding	46 (37)
- Prophylaxis before admission:
• None2	11 (24)
• Sclerosis	2 (4)
• Ligation	4 (9)
• Beta-blockade	13 (28)
• Ligation/sclerosis plus beta-blockade/nitrate derivative	16 (35)

¹Missing data: one death shortly after admission;

²Cirrhosis had not been diagnosed at the time of the previous hemorrhage in three patients.

Table 3 Management of the bleeding event in 126 consecutive patients: conformity with the Baveno III consensus and regional variability

Baveno III guidelines	n (%) of cases complying with the guidelines(95% confidence limits)	Variability among sectors(range, P a)
Endoscopy within 12 h after admission from home	60 (60%) (50%-70%)	52% to 71% P = 0.85
Blood restitution to maintain hematocrit at 25% to 30%	84 (89%) (81%-95%)	ND
	(n = 94 patients transfused)
Early vasoactive drug infusion	110 (87%) (80%-92%)	71% to 100% P = 0.081
	Median time after admission: 2 h
Endoscopic treatment: ligation or sclerosis	- Ligation 52 (42%) (33%-51%)	29% to 61% P = 0.17
	- Sclerosis 26 (21%) (14%-29%)	7% to 43% P = 0.29
Antibiotic prophylaxis	81 (64%) (55%-73%)	50% to 75% P = 0.41
	Prophylaxis 87%/infection 13%
Lactulose administration	50 (40%) (32%-49%)	26% to 86% P = 0.041
	Prophylaxis 57%/encephalopathy 43%
Prophylaxis of rebleeding: beta blockers or ligation	- Beta-blockers alone 31% (22%-41%)	0 to 45%
	- Ligation and beta-blockers 33%	16% to 100%
	(24%-43%)
	- Ligation alone 19% (12%-29%)	0 to 37%
	- Others or none 17% (10%-26%)	0 to 44%
		P = 0.0003

ND: variability not assessed.

^aGeneralized Fisher’s exact test of the homogeneity in practices among the six geographic sectors (five regions and two combined counties).