Effects of postoperative use of proton pump inhibitors on gastrointestinal bleeding after endoscopic variceal treatment during hospitalization

Table 1 Comparison of baseline characteristics between proton pump inhibitors and non-proton pump inhibitors groups

Variables	Overall		PPIs		Non-PPIs		P value
	No.Pts	Median (range), mean ± SD, or frequency (percentage)	No.Pts	Median (range), mean ± SD, or frequency (percentage)	No.Pts	Median (range), mean ± SD, or frequency (percentage)
Age (yr)	143	56.00 (28.00-88.00)	83	58.00 (30.00-88.00)	60	54.50 (28.00-79.00)	0.089
		55.88 ± 11.77		57.40 ± 11.86		53.78 ± 11.41
Male	143	104 (72.73%)	83	61 (73.49%)	60	43 (71.67%)	0.809
HBV infection alone	143	52 (36.36%)	83	31 (37.35%)	60	21 (35.00%)	0.773
HCV infection alone	143	11 (7.69%)	83	4 (4.82%)	60	7 (11.67%)	0.202
Alcohol abuse alone	143	33 (23.08%)	83	22 (26.51%)	60	11 (18.33%)	0.252
White blood cell (109/L)	141	3.50 (0.80-19.60)	81	3.60 (0.80-19.60)	60	3.45 (1.00-17.40)	0.381
		3.99 ± 2.60		4.15 ± 2.74		3.78 ± 2.40
Hemoglobin (g/L)	141	89.00 (48.00-155.00)	81	83.00 (48.00-155.00)	60	97.50 (57.00-149.00)	0.081
		93.21 ± 26.69		90.15 ± 27.48		97.35 ± 25.23
Platelet count (109/L)	141	75.00 (15.00-470.00)	81	76.00 (22.00-268.00)	60	71.00 (15.00-470.00)	0.970
		92.58 ± 66.85		87.80 ± 52.28		99.03 ± 82.61
Total bilirubin (μmol/L)	132	20.40 (5.60-106.10)	74	24.35 (7.00-106.10)	58	16.30 (5.60-96.60)	0.006
		25.67 ± 18.53		28.72 ± 19.92		21.78 ± 15.91
Albumin (g/L)	133	33.40 (20.50-48.70)	75	31.80 (20.50-45.70)	58	35.30 (21.80-48.70)	0.048
		33.21 ± 5.91		32.41 ± 5.48		34.26 ± 6.32
Alanine aminotransferase (U/L)	132	20.92 (4.47-1465.50)	74	19.40 (7.57-1465.50)	58	23.62 (4.47-185.02)	0.228
		38.52 ± 127.21		43.85 ± 168.05		31.72 ± 30.61
Serum creatinine (μmol/L)	135	64.93 (34.51-501.52)	76	64.52 (34.51-117.66)	59	65.21 (36.39-501.52)	0.591
		70.77 ± 42.31		66.97 ± 18.75		75.68 ± 60.31
Sodium (mmol/L)	134	138.85 (124.00-151.00)	75	138.70 (124.00-151.00)	59	139.00 (133.10-147.70)	0.798
		138.55 ± 3.38		138.49 ± 3.65		138.64 ± 3.04
International normalized ratio	135	1.29 (0.90-2.55)	75	1.29 (0.90-2.55)	60	1.31 (0.92-2.04)	0.685
		1.36 ± 0.26		1.37 ± 0.27		1.35 ± 0.25
MELD score	129	10.24 (6.65-30.03)	71	10.51 (6.65-30.03)	58	9.93 (7.14-22.06)	0.214
		11.44 ± 3.78		11.75 ± 4.03		11.05 ± 3.45
Child-Pugh score	130	6.00 (5.00-12.00)	72	7.00 (5.00-12.00)	58	6.00 (5.00-10.00)	0.388
		6.76 ± 1.59		6.89 ± 1.68		6.60 ± 1.47
Child-Pugh class
A		66 (50.77%)		35 (48.61%)		31 (53.45%)
B	130	57 (43.85%)	72	32 (44.44%)	58	25 (43.10%)	0.709
C		7 (5.38%)		5 (6.94%)		2 (3.45%)
Ascites	143	75 (52.45%)	83	45 (54.22%)	60	30 (50.00%)	0.618
Jaundice	132	12 (9.09%)	74	9 (12.16%)	58	3 (5.17%)	0.166
Hepatic encephalopathy	143	1 (0.70%)	83	0 (0.00%)	60	1 (1.67%)	0.420
Portal venous system thrombosis	90	39 (43.33%)	55	25 (45.45%)	35	14 (40.00%)	0.611
Hepatocellular carcinoma	143	10 (6.99%)	83	6 (7.23%)	60	4 (6.67%)	1.000

PPIs: Proton pump inhibitors; No. Pts: Numbers of patients; SD: Standard deviation; HBV: Hepatitis B virus; HCV: Hepatitis C virus; MELD: Model for end-stage liver disease.

Table 2 Comparison of endoscopic findings, treatment, and outcomes between proton pump inhibitors and non-proton pump inhibitors groups

Variables	Overall		PPIs		Non-PPIs		P value
	No.Pts	Frequency (percentage)	No.Pts	Frequency (percentage)	No.Pts	Frequency (percentage)
Grade of esophageal varices
Mild		27 (19.01%)		14 (17.07%)		13 (21.67%)
Moderate	142	35 (24.65%)	82	21 (25.61%)	60	14 (23.33%)	0.783
Severe		80 (56.34%)		47 (57.32%)		33 (55.00%)
Red sign of esophageal varices	143	98 (68.53%)	83	57 (68.67%)	60	41 (68.33%)	0.965
Active bleeding	143	5 (3.50%)	83	5 (6.02%)	60	0 (0.00%)	0.074
Indication of EVT
Treatment		56 (39.16%)		34 (40.96%)		22 (36.67%)
Primary prophylaxis	143	11 (7.69%)	83	10 (12.05%)	60	1 (1.67%)	0.035
Secondary prophylaxis		76 (53.15%)		39 (46.99%)		37 (61.67%)
Type of EVT
EVL		80 (55.94%)		46 (55.42%)		34 (56.67%)
ECGI		14 (9.79%)		6 (7.23%)		8 (13.33%)
EIS	143	6 (4.20%)	83	4 (4.82%)	60	2 (3.33%)	0.799
EVL+ECGI		41 (28.67%)		25 (30.12%)		16 (26.67%)
EIS+ECGI		1 (0.70%)		1 (1.20%)		0 (0.00%)
EVL+ECGI+EIS		1 (0.70%)		1 (1.20%)		0 (0.00%)
PPIs before the index EVT	143	66 (46.15%)	83	42 (50.60%)	60	24 (40.00%)	0.209
Vasoactive drugs after the index EVT	143	38 (26.57%)	83	27 (32.53%)	60	11 (18.33%)	0.058
Post-EVT GIB	143	7 (4.90%)	83	3 (3.61%)	60	4 (6.67%)	0.453
Other post-EVT complications	143	67 (46.85%)	83	37 (44.58%)	60	30 (50.00%)	0.521

PPIs: Proton pump inhibitors; No. Pts; Numbers of patients; EVT: Endoscopic variceal treatment; EVL: Endoscopic variceal ligation; ECGI: Endoscopic cyanoacrylate glue injection; EIS: Endoscopic injection sclerotherapy; GIB: Gastrointestinal bleeding.