Gender differences in esophageal variceal bleeding in the United States

Sohal, Aalam; Chaudhry, Hunza; Dhaliwal, Armaan; Singla, Piyush; Gupta, Gagan; Sharma, Raghav; Dukovic, Dino; Prajapati, Devang

doi:10.1080/07853890.2022.2104920

Cited by 9 publications

(6 citation statements)

References 32 publications

(26 reference statements)

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“…Other studies have suggested that males typically have worse in-hospital outcomes than females with variceal bleeding. 19 Our study may not have been able to see the same result given the significant proportion of female patients in the VB group.…”

Section: Discussionmentioning

confidence: 62%

Outcomes of Upper Gastrointestinal Bleeding in Hospitalized COVID-19 Patients in the United States: A Propensity-Score Matched Analysis of A Large National Database

Ryu,

Quazi,

Ghosh

et al. 2024

Journal of Community Hospital Internal Medicine Perspectives

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Patients with cirrhosis that are hospitalized with COVID-19 infection have been found to have worse outcomes. No comparative study has been conducted between gastrointestinal (GI) bleeding in patients with cirrhosis who are diagnosed with COVID-19. We utilized the National Inpatient Sample (NIS) database to perform a retrospective analysis of 24, 050 patients diagnosed with cirrhosis and COVID-19. The identified patients were separated into variceal bleeding, nonvariceal bleeding, and no (or neither) GI bleeding groups. After performing propensity sample matching and multivariate analysis of mortality, we found no significant differences in mortality among the three groups. However, the variceal bleed group had a shorter length of stay (5.67 days lower than the no-bleed group). Esophagogastroduodenoscopy (EGD) with intervention was associated with reduced mortality in the variceal and nonvariceal bleeding groups. Acute kidney injury was a strong predictor of mortality in both bleeding groups. A native American race was found to be associated with higher mortality in the nonvariceal bleeding group. Our study suggests that there are various pathophysiological processes among the three groups, with no significant mortality differences with cirrhosis complications of GI bleeding.

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Section: Discussionmentioning

confidence: 62%

Outcomes of Upper Gastrointestinal Bleeding in Hospitalized COVID-19 Patients in the United States: A Propensity-Score Matched Analysis of A Large National Database

Ryu,

Quazi,

Ghosh

et al. 2024

Journal of Community Hospital Internal Medicine Perspectives

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“…However, the difference between the two groups is insignificant. To explain the gender finding in the control group, the typical history of liver disease showed that 55% and 70% of all cases were in men (Sohal et al, 2022). From the researchers' point of view, half of the study group consisted of female patients because female patients may develop liver cirrhosis later than males related to the protective activity of estrogen (Lee et al,…”

Section: Resultsmentioning

confidence: 99%

“…This rise is caused by scar tissue or a clot restricting the liver's normal blood supply. Varices form when blood bypasses the larger vessels and flows through the small vessels in the esophagus (Sohal et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Educational Bundle on Patients’ Clinical Outcomes Post-Esophageal Varices Treatment

Elsayed Mosaad Mohammed,

Ibrahim Abdelkader khider,

Mohammed Mahmoud El hapashy

2023

Egyptian Journal of Health Care

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Background: Esophageal varices are one of the most significant comorbidity-related complications of liver cirrhosis. Patients with esophageal varices reported unsatisfactory levels of knowledge and fatigue, as well as recurrent hospital readmissions. The aim: The study aimed to assess the efficacy of the educational bundle on patients' clinical outcomes post-esophageal varices treatment. Setting: This study was done in the Gastroenterology and Hepatology department at Specialised Medical Hospital. Research design: This research employed a quasi-experimental design. Sampling: A purposive sample of one hundred patients with esophageal varices was recruited. Tools: This study utilized three tools to acquire relevant data. Tool I was the patients' assessment questionnaire, Tool II was the patients' knowledge questionnaire, and Tool III was the modified fatigue impact scale. Results: The current study showed that after using the educational bundle, 46% of the study group and only 2% of the control group had a satisfactory knowledge level, showing a statistically significant difference (p=0.007) between the two groups. Moreover, after two weeks of receiving the educational bundle, 94% of the study group and 80% of the control group had mild fatigue levels, showing a statistically significant difference. Regarding the readmission rate, there was a highly statistically significant difference between the two groups after three months of implementing the educational bundle. Conclusion: The educational bundle significantly improved the clinical outcomes of the study groups' post-esophageal treatment in knowledge, fatigue levels and hospital readmission. Recommendations: Patients with esophageal varices should receive the educational bundle as standard treatment.

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“…The database has been described in detail previously. 24 , 25 , 26 Since the data obtained is publicly available de‐identified data, IRB approval was not required.…”

Section: Methodsmentioning

confidence: 99%

Outcomes among patients with hepatorenal syndrome based on hospital teaching and transplant status: Analysis of 159 845 hospitalizations

Sohal,

Chaudhry,

Dukovic

et al. 2023

JGH Open

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Background and AimHepatorenal syndrome (HRS) is a life‐threatening complication of advanced liver disease. This study aimed to examine the impact of hospital teaching/transplant status and availability of liver transplantation on survival among hospitalized patients with HRS in the United States.MethodsPatients with HRS were identified from the national inpatient sample 2016–2019. Information was collected regarding patient demographics, hospital characteristics, liver disease etiology, presence of liver disease decompensations, Elixhauser comorbidities, and interventions. Patients were classified as being treated at three hospital groups: non‐teaching hospitals (NTHs), teaching non‐transplant centers (TNTCs), and teaching transplant centers (TTCs). The relationship between hospital teaching/transplant status and in‐hospital mortality and transplant‐free mortality was examined using multivariable linear and logistic regression analysis.ResultsA total of 159,845 patients met the criteria for HRS. Of these, 24% were admitted to NTHs, 50.8% to TNTCs, and 25.2% to TTCs. Admission to a TTC was independently associated with a lower mortality risk compared to admission to non‐TTCs (aOR = 0.75, 95% CI: 0.68–0.83, P <0.001). Patients at TTCs had a lower transplant‐free mortality risk than those at NTHs (aOR = 0.75, 95% CI: 0.67–0.83, P < 0.001). There was no significant difference in all‐cause or transplant‐free mortality between TNTCs and NTHs.ConclusionPatients with HRS admitted to TTCs have higher disease severity, but significantly improved outcomes compared to those admitted to NTHs. These data suggest opportunities for increased disease awareness and education among NTHs and support early referral for liver transplant evaluation among hospitalized patients with HRS.

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Gender differences in esophageal variceal bleeding in the United States

Cited by 9 publications

References 32 publications

Outcomes of Upper Gastrointestinal Bleeding in Hospitalized COVID-19 Patients in the United States: A Propensity-Score Matched Analysis of A Large National Database

Outcomes of Upper Gastrointestinal Bleeding in Hospitalized COVID-19 Patients in the United States: A Propensity-Score Matched Analysis of A Large National Database

Efficacy of Educational Bundle on Patients’ Clinical Outcomes Post-Esophageal Varices Treatment

Outcomes among patients with hepatorenal syndrome based on hospital teaching and transplant status: Analysis of 159 845 hospitalizations

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