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Outcomes in Variceal Bleeding Associated With Continuous Octreotide in Patients With Delayed Endoscopy.
Laws, Matthew B; Wahking, Rebekah; Blackburn, Erin; Williams, Whitney; Schadler, Aric; Fritz, Megan Kunka.
Afiliação
  • Laws MB; Department of Pharmacy, University of Kentucky HealthCare, Lexington, KY, USA.
  • Wahking R; Department of Pharmacy, University of Kentucky HealthCare, Lexington, KY, USA.
  • Blackburn E; Department of Pharmacy, University of Kentucky HealthCare, Lexington, KY, USA.
  • Williams W; Department of Pharmacy, University of Kentucky HealthCare, Lexington, KY, USA.
  • Schadler A; College of Pharmacy, University of Kentucky, Lexington, KY, USA.
  • Fritz MK; Department of Pharmacy, University of Kentucky HealthCare, Lexington, KY, USA.
J Pharm Pract ; 37(5): 1107-1115, 2024 Oct.
Article em En | MEDLINE | ID: mdl-38240733
ABSTRACT

Background:

Variceal hemorrhage treatment includes endoscopy within 12 hours of admission and octreotide therapy for 2-5 days post-endoscopy. Duration of pre-endoscopy octreotide can be prolonged when intervention is delayed.

Objective:

This study aimed to evaluate the impact of extended pre-endoscopy octreotide on rebleeding after endoscopy when comparing short vs long durations of post-endoscopy octreotide.

Methods:

This was a single center, retrospective cohort evaluating adult cirrhotic patients with esophageal variceal hemorrhage admitted between July 1, 2017 and June 30, 2020. Study groups included patients receiving octreotide ≥12 hours prior to endoscopy followed by ≤ 48 (short course) or >48 hours (standard course) after endoscopy. The primary outcome was post-endoscopy rebleeding, defined as hemoglobin decrease of ≥2 g/dL from baseline or the requirement of ≥1 unit of packed red blood cells.

Results:

Of the 169 patients included, 88 patients received short course octreotide after endoscopy, and 81 patients received standard course octreotide after endoscopy. Twenty-nine (33%) patients in the short course group and 43 (53.1%) in the standard course group experienced the primary endpoint (OR 2.3, 95% CI 1.24 - 4.29; P = .008).

Conclusion:

Extended pre-endoscopy octreotide may be beneficial in preventing rebleeding when intervention is delayed. Further studies are needed to determine the necessary octreotide duration in delayed endoscopy and varying bleeding risk.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fármacos Gastrointestinais / Octreotida / Varizes Esofágicas e Gástricas / Hemorragia Gastrointestinal Tipo de estudo: Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Pharm Pract Assunto da revista: FARMACIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fármacos Gastrointestinais / Octreotida / Varizes Esofágicas e Gástricas / Hemorragia Gastrointestinal Tipo de estudo: Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Pharm Pract Assunto da revista: FARMACIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Estados Unidos