AIM To examine the association between the timing of endo-scopy and the short-term outcomes of acute variceal bleeding in cirrhotic patients.METHODS This retrospective study included 274 consecutive patients admitted ...AIM To examine the association between the timing of endo-scopy and the short-term outcomes of acute variceal bleeding in cirrhotic patients.METHODS This retrospective study included 274 consecutive patients admitted with acute esophageal variceal bleeding of two tertiary hospitals in Korea. We adjusted confounding factors using the Cox proportional hazards model and the inverse probability weighting （IPW） method. The primary outcome was the mortality of patients within 6 wk.RESULTS A total of 173 patients received urgent endoscopy （ i.e. , ≤ 12 h after admission）, and 101 patients received non-urgent endoscopy （〉 12 h after admission）. The 6-wk mortality rate was 22.5% in the urgent endoscopy group and 29.7% in the non-urgent endoscopy group, and there was no significant difference between the two groups before （P = 0.266） and after IPW （P = 0.639）. The length of hospital stay was statistically different between the urgent group and non-urgent group （P = 0.033）; however, there was no significant difference in the in-hospital mortality rate between the two groups （8.1%vs 7.9%, P = 0.960）. In multivariate analyses, timing of endoscopy was not associated with 6-wk mortality （hazard ratio, 1.297; 95% confdence interval, 0.806-2.089; P = 0.284）.CONCLUSION In cirrhotic patients with acute variceal bleeding, the timing of endoscopy may be independent of short-term mortality.展开更多
A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skul! ba...A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skul! base. The patient＇s death occurred due to the very low thickness of the calvarial bones, which led to the aforementioned fracture, and in turn resulted in subarachnoid hemorrhage and death. The cortical thickness was measured and compared with average values at standardized points. Uniform bone thinning was confirmed rather than localized. Calvarial thinning may result from various conditions. In the present case study, however, the exact mechanism which led to the low thickness of the calvarial bones of the patient is undetermined. Death due to the susceptible structure and fracture of calvarial bones has rarely been reported throughout relevant literature.展开更多
文摘AIM To examine the association between the timing of endo-scopy and the short-term outcomes of acute variceal bleeding in cirrhotic patients.METHODS This retrospective study included 274 consecutive patients admitted with acute esophageal variceal bleeding of two tertiary hospitals in Korea. We adjusted confounding factors using the Cox proportional hazards model and the inverse probability weighting （IPW） method. The primary outcome was the mortality of patients within 6 wk.RESULTS A total of 173 patients received urgent endoscopy （ i.e. , ≤ 12 h after admission）, and 101 patients received non-urgent endoscopy （〉 12 h after admission）. The 6-wk mortality rate was 22.5% in the urgent endoscopy group and 29.7% in the non-urgent endoscopy group, and there was no significant difference between the two groups before （P = 0.266） and after IPW （P = 0.639）. The length of hospital stay was statistically different between the urgent group and non-urgent group （P = 0.033）; however, there was no significant difference in the in-hospital mortality rate between the two groups （8.1%vs 7.9%, P = 0.960）. In multivariate analyses, timing of endoscopy was not associated with 6-wk mortality （hazard ratio, 1.297; 95% confdence interval, 0.806-2.089; P = 0.284）.CONCLUSION In cirrhotic patients with acute variceal bleeding, the timing of endoscopy may be independent of short-term mortality.
文摘A 45-year-old male was autopsied. He had fallen backwards from a two-stairs height to the ground and passed away. A skull fracture was detected in the left occipital area, extending up to the left side of the skul! base. The patient＇s death occurred due to the very low thickness of the calvarial bones, which led to the aforementioned fracture, and in turn resulted in subarachnoid hemorrhage and death. The cortical thickness was measured and compared with average values at standardized points. Uniform bone thinning was confirmed rather than localized. Calvarial thinning may result from various conditions. In the present case study, however, the exact mechanism which led to the low thickness of the calvarial bones of the patient is undetermined. Death due to the susceptible structure and fracture of calvarial bones has rarely been reported throughout relevant literature.
