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Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: A prospective study of factors associated with rebleeding

✍ Scribed by Thierry Poynard; Didier Lebrec; Patrick Hillon; Raymond Sayegh; Jacques Bernuau; Sylvie Naveau; Jean-Claude Chaput; Claude Klepping; Bernard Rueff; Jean-Pierre Benhamou

Publisher: John Wiley and Sons
Year: 1987
Tongue: English
Weight: 578 KB
Volume: 7
Category: Article
ISSN: 0270-9139
DOI: 10.1002/hep.1840070306

No coin nor oath required. For personal study only.

✦ Synopsis

In a previous randomized trial, we demonstrated that propranolol prevented recurrent gastrointestinal bleeding in patients with cirrhosis. We have undertaken the present study in a new group of patients to ascertain the factors associated with rebleeding. Among 232 patients with cirrhosis admitted for gastrointestinal bleeding, 127 were included. They received propranolol orally at a dose reducing the heart rate by 25%. The median follow-up period was 682 days. The following factors were studied: cause of cirrhosis; severity of cirrhosis; hepatocellular carcinoma recognized after inclusion; compliance; persistent decrease in heart rate; dose of propranolol; alcohol abstinence; previous history of hemorrhage; time interval from hemorrhage to onset of propranolol administration, and source of bleeding. The percentage of patients free of rebleeding was 71% at 1 year and 57% at 2 years. Only five factors were significantly and independently associated with rebleeding: occurrence of hepatocellular carcinoma; lack of compliance; lack of persistent decrease in heart rate; lack of abstinence, and previous history of bleeding. In conclusion, this study confirms the results of our previous trial and suggests that certain factors play a role in the mechanism of rebleeding in patients receiving propranolol.

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