A comprehensive systematic review and meta-analysis of risk factors for rebleeding following device-assisted enteroscopy therapy of small-bowel vascular lesions
Rev. esp. enferm. dig
; 112(4): 249-257, abr. 2020. graf, tab
Artigo
em Inglês
| IBECS
| ID: ibc-187502
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
INTRODUCTION:
the aim of this study was to determine the risk factors for rebleeding following device-assisted enteroscopy therapy of small bowel vascular lesions.METHODS:
this is a systematic review and meta-analysis. A literature search was performed from January 2003 to October 2019. All studies reporting on at least one risk factor for bleeding recurrence after endoscopic therapy of small bowel vascular lesions were included. A meta-analysis of those risk factors reported in at least three studies was performed to assess their association with rebleeding. The OR and 95 % CI were used for binary outcome data. Heterogeneity analysis was performed using the Tau and I2 index. If I2 > 20 %, potential sources of heterogeneity were identified by sensitivity analyses and a random-effect model was used.RESULTS:
the search identified a total of 572 articles and 35 full-text records were assessed for eligibility after screening. Finally, eight studies that included 548 patients were selected. The overall median rebleeding rate was 38.5 % (range 10.9-53.3 %) with a median follow-up of 24.5 months. Female sex (OR 1.96, 95 % CI 1.14-3.37, p = 0.01, I2 = 0 %), Osler-Weber syndrome (OR 4.35, 95 % CI 1.22-15.45, p = 0.02, I2 = 0 %) and cardiac disease (OR 1.89, 95 % CI 1.12-2.97, p = 0.005, I2 0 %) were associated with rebleeding. According to the sensitivity analysis, overt bleeding (OR 2.13, 95 % CI 1.22-3.70, p = 0.007, I2 = 0 %), multiple lesions (OR 4.57, 95 % CI 2.04-10.22, p < 0.001, I2 = 0 %) and liver cirrhosis (OR 2.61, 95 % CI 1.11-6.13, p = 0.03, I2 = 0 %) were also predictors for rebleeding.CONCLUSIONS:
patient characteristics and comorbidities should be considered for follow-up patient management after effective device-assisted endoscopic therapy, as they can predict rebleedingRESUMEN
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Coleções:
Bases de dados nacionais
/
Espanha
Base de dados:
IBECS
Assunto principal:
Enteroscopia de Balão
/
Hemorragia Gastrointestinal
/
Enteropatias
/
Intestino Delgado
Limite:
Humanos
Idioma:
Inglês
Revista:
Rev. esp. enferm. dig
Ano de publicação:
2020
Tipo de documento:
Artigo
Instituição/País de afiliação:
Cliniques Universitaires Saint-Luc/Belgium
/
Georges-Pompidou European Hospital/France
/
Hospital General Universitario Morales Meseguer/Spain
/
Hotel Dieu de France/Lebanon
/
Instituto Mexicano del Seguro Social/México
/
National Institute of Medical Sciences and Nutrition Salvador Zubirán/Mexico