Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasis
Background and study aims Hemodialysis (HD) is considered one of the risk factors for post-endoscopic sphincterotomy (ES) bleeding. Therefore, we conducted a retrospective study to evaluate HD as a risk factor for post-ES bleeding in patients with choledocholithiasis. Patients and method...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2018-05-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0587-4470 |
| _version_ | 1811289738723721216 |
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| author | So Nakaji Nobuto Hirata Hiroki Matsui Toshiyasu Shiratori Masayoshi Kobayashi Shigenobu Yoshimura Keisuke Kanda Natsuki Kawamitsu Hisato Harasawa |
| author_facet | So Nakaji Nobuto Hirata Hiroki Matsui Toshiyasu Shiratori Masayoshi Kobayashi Shigenobu Yoshimura Keisuke Kanda Natsuki Kawamitsu Hisato Harasawa |
| author_sort | So Nakaji |
| collection | DOAJ |
| description | Background and study aims Hemodialysis (HD) is considered one of the risk factors for post-endoscopic sphincterotomy (ES) bleeding. Therefore, we conducted a retrospective study to evaluate HD as a risk factor for post-ES bleeding in patients with choledocholithiasis.
Patients and methods We used the post-ES bleeding rate as the main outcome measure. To evaluate the influence of HD on the risk of post-ES bleeding, logistic regression and propensity score analyses were conducted. In addition, univariate analysis-based comparisons of various clinical parameters (as secondary outcome measures) were performed between the patients in the HD and non-HD groups that experienced post-ES bleeding.
Results A total of 1518 patients were enrolled. In the multivariate analysis, a platelet count of < 50,000, anticoagulant therapy, bleeding during ES, and HD were found to be significantly associated with post-ES bleeding (odds ratio [OR]: 35.30, 95 % confidence interval [CI]: 3.81 – 328.00; OR: 4.39, 95 % CI: 1.53 – 12.60; OR: 4.28, 95 % CI: 2.30 – 7.97; and OR: 13.30, 95 % CI: 5.78 – 30.80, respectively). Propensity score matching created 28 matched pairs. Propensity score analysis showed that the risk difference between the groups was 0.214 (95 % CI: 0.022 – 0.407). In a comparison between the patients in the HD and non-HD groups that suffered post-ES bleeding, it was found that the post-ES bleeding was significantly more severe in the HD group (p = 0.033), and massive blood transfusions and long periods of hospitalization were more frequently required in the HD group (p = 0.008 and p < 0.001, respectively).
Conclusion HD is an independent risk factor for post-ES bleeding and makes post-ES bleeding more serious. |
| first_indexed | 2024-04-13T03:59:44Z |
| format | Article |
| id | doaj.art-38bc17db080748b09f9907443e8c2879 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-13T03:59:44Z |
| publishDate | 2018-05-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-38bc17db080748b09f9907443e8c28792022-12-22T03:03:30ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362018-05-010605E568E57410.1055/a-0587-4470Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasisSo Nakaji0Nobuto Hirata1Hiroki Matsui2Toshiyasu Shiratori3Masayoshi Kobayashi4Shigenobu Yoshimura5Keisuke Kanda6Natsuki Kawamitsu7Hisato Harasawa8Department of Gastroenterology, Kameda Medical Center, Kamogawa City, JapanDepartment of Gastroenterology, Kameda Medical Center, Kamogawa City, JapanClinical Research Support Division, Kameda Institute for Health Science, Kameda College of Health Sciences, Kamogawa City, JapanDepartment of Gastroenterology, Kameda Medical Center, Kamogawa City, JapanDepartment of Gastroenterology, Kameda Medical Center, Kamogawa City, JapanDepartment of Gastroenterology, Kameda Medical Center, Kamogawa City, JapanDepartment of Gastroenterology, Kameda Medical Center, Kamogawa City, JapanDepartment of Gastroenterology, Kameda Medical Center, Kamogawa City, JapanDepartment of Gastroenterology, Kameda Medical Center, Kamogawa City, JapanBackground and study aims Hemodialysis (HD) is considered one of the risk factors for post-endoscopic sphincterotomy (ES) bleeding. Therefore, we conducted a retrospective study to evaluate HD as a risk factor for post-ES bleeding in patients with choledocholithiasis. Patients and methods We used the post-ES bleeding rate as the main outcome measure. To evaluate the influence of HD on the risk of post-ES bleeding, logistic regression and propensity score analyses were conducted. In addition, univariate analysis-based comparisons of various clinical parameters (as secondary outcome measures) were performed between the patients in the HD and non-HD groups that experienced post-ES bleeding. Results A total of 1518 patients were enrolled. In the multivariate analysis, a platelet count of < 50,000, anticoagulant therapy, bleeding during ES, and HD were found to be significantly associated with post-ES bleeding (odds ratio [OR]: 35.30, 95 % confidence interval [CI]: 3.81 – 328.00; OR: 4.39, 95 % CI: 1.53 – 12.60; OR: 4.28, 95 % CI: 2.30 – 7.97; and OR: 13.30, 95 % CI: 5.78 – 30.80, respectively). Propensity score matching created 28 matched pairs. Propensity score analysis showed that the risk difference between the groups was 0.214 (95 % CI: 0.022 – 0.407). In a comparison between the patients in the HD and non-HD groups that suffered post-ES bleeding, it was found that the post-ES bleeding was significantly more severe in the HD group (p = 0.033), and massive blood transfusions and long periods of hospitalization were more frequently required in the HD group (p = 0.008 and p < 0.001, respectively). Conclusion HD is an independent risk factor for post-ES bleeding and makes post-ES bleeding more serious.http://www.thieme-connect.de/DOI/DOI?10.1055/a-0587-4470 |
| spellingShingle | So Nakaji Nobuto Hirata Hiroki Matsui Toshiyasu Shiratori Masayoshi Kobayashi Shigenobu Yoshimura Keisuke Kanda Natsuki Kawamitsu Hisato Harasawa Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasis Endoscopy International Open |
| title | Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasis |
| title_full | Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasis |
| title_fullStr | Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasis |
| title_full_unstemmed | Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasis |
| title_short | Hemodialysis is a strong risk factor for post-endoscopic sphincterotomy bleeding in patients with choledocholithiasis |
| title_sort | hemodialysis is a strong risk factor for post endoscopic sphincterotomy bleeding in patients with choledocholithiasis |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-0587-4470 |
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