Keung CY, Morgan A, Le ST, Robertson M, Urquhart P, Swan MP. Survival outcomes and predictors of mortality, re-bleeding and complications for acute severe variceal bleeding requiring balloon tamponade. World J Hepatol 2022; 14(8): 1584-1597 [PMID: 36157875 DOI: 10.4254/wjh.v14.i8.1584]
Corresponding Author of This Article
Charlotte Y Keung, FRACP, MBBS, Academic Fellow, Doctor, Department of Gastroenterology, Monash Health, 246 Clayton Road, Clayton, Melbourne 3168, Victoria, Australia. charlotte.keung@monashhealth.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Aug 27, 2022; 14(8): 1584-1597 Published online Aug 27, 2022. doi: 10.4254/wjh.v14.i8.1584
Survival outcomes and predictors of mortality, re-bleeding and complications for acute severe variceal bleeding requiring balloon tamponade
Charlotte Y Keung, Aparna Morgan, Suong T Le, Marcus Robertson, Paul Urquhart, Michael P Swan
Charlotte Y Keung, Aparna Morgan, Suong T Le, Marcus Robertson, Michael P Swan, Department of Gastroenterology, Monash Health, Melbourne 3168, Victoria, Australia
Charlotte Y Keung, Paul Urquhart, Department of Gastroenterology, Eastern Health, Melbourne 3128, Victoria, Australia
Charlotte Y Keung, Suong T Le, Marcus Robertson, Department of Medicine, Monash University, Melbourne 3168, Victoria, Australia
Suong T Le, Monash Digital Therapeutics and Innovation Laboratory, Monash University, Melbourne 3168, Victoria, Australia
Author contributions: Keung C designed the study, collected and analysed data and wrote the manuscript; Morgan A collected data and wrote the manuscript; Le ST reviewed the statistical analysis and performed critical revisions of the manuscript; Robertson M performed critical revisions of the manuscript; Urquhart P performed critical revisions of the manuscript; Swan M designed and supervised the study and performed critical revisions of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Monash Health Human Research Ethics Committee (RES-21-0000-218Q-70254).
Informed consent statement: Patients were not required to give informed consent to this study and the analysis used anonymous clinical data.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
STROBE statement: All authors have read the STROBE Statement checklist of items and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Charlotte Y Keung, FRACP, MBBS, Academic Fellow, Doctor, Department of Gastroenterology, Monash Health, 246 Clayton Road, Clayton, Melbourne 3168, Victoria, Australia. charlotte.keung@monashhealth.org
Received: March 30, 2022 Peer-review started: March 30, 2022 First decision: June 8, 2022 Revised: June 22, 2022 Accepted: July 26, 2022 Article in press: July 26, 2022 Published online: August 27, 2022 Processing time: 148 Days and 21.9 Hours
Core Tip
Core Tip: Acute severe variceal bleeding requiring balloon tamponade remains associated with high mortality rates of approximately 50%. Sengstaken-Blakemore tube achieves excellent primary haemostasis rates in > 90% however re-bleeding is common at approximately 30% with subsequent death in approximately 75%. Predictors of all-cause mortality at 6 wk included a greater Model for Endstage Liver disease score, re-bleeding and advanced hepatocellular carcinoma. The most commonly reported complication from SBT was mucosal trauma, which was conservatively managed, with only a small proportion resulting in serious complications (6.3%). There was significant variability amongst technical aspects of balloon tamponade insertion which may result from the infrequent need to perform this procedure.