Efficacy of hemostatic powders in upper gastrointestinal bleeding: A systematic review and meta-analysis.
Dig Liver Dis
; 51(12): 1633-1640, 2019 12.
Article
en En
| MEDLINE
| ID: mdl-31401022
ABSTRACT
BACKGROUND:
There is limited evidence on the efficacy of hemostatic powders in the management of upper gastrointestinal bleeding.AIMS:
Provide a pooled estimate of the efficacy and safety profile of hemostatic powders in digestive endoscopy.METHODS:
A computerized bibliographic search on the main databases was performed through December 2018. Pooled effects were calculated using a random-effects model. The primary outcome was immediate hemostasis rate. Secondary outcomes were rebleeding rate (either at 7 and 30 days), bleeding-related mortality, and all-cause mortality rate.RESULTS:
A total of 24 studies, of which three were randomized-controlled trials, with 1063 patients were included in the meta-analysis. Immediate hemostasis was achieved in 95.3% (93.3%-97.3%) of patients, with no difference based on treatment strategy, hemostatic agent used, bleeding etiology. Success rate was slightly lower in spurting bleeding (91.9%). Hemostatic powders showed similar efficacy as compared to conventional endoscopic therapy (odds ratio 0.84, 0.06-11.47; pâ¯=â¯0.9). Thirty-day rebleeding rate was 16.9% (9.8%-24%) with no difference in comparison to other endoscopic treatments (odds ratio 1.59, 0.35-7.21; pâ¯=â¯0.55). All-cause and bleeding-related mortality rates were 7.6% (4%-10.8%) and 1.4% (0.5%-2.4%), respectively.CONCLUSION:
Novel hemostatic powders represent a user-friendly and effective tool in the management of upper gastrointestinal bleeding.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Polvos
/
Hemostasis Endoscópica
/
Tracto Gastrointestinal Superior
/
Hemorragia Gastrointestinal
/
Minerales
Tipo de estudio:
Clinical_trials
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Año:
2019
Tipo del documento:
Article