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KMID : 0338420180330040696
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The Korean Journal of Internal Medicine
2018 Volume.33 No. 4 p.696 ~ p.704
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Outcomes of patients treated with Sengstaken-Blakemore tube for uncontrolled variceal hemorrhage
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Choi Ja-Yun
Jo Yun-Won
Lee Sang-Soo
Kim Wan-Soo
Oh Hye-Won
Kim Cha-Young
Yun Eun-Young
Kim Jin-Joo
Lee Jae-Min
Kim Hong-Jun
Kim Hyun-Jin
Kim Tae-Hyo
Jung Woon-Tae
Lee Ok-Jae
Kim Rock-Bum
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Abstract
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Background/Aims: The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment.
Methods: The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed.
Results: The overall success rate of initial hemostasis with SB tube was 75.8%, and the independent factors associated with hemostasis were non-intubated state before SB tube (odds ratio, 8.50; p = 0.007) and Child-Pugh score < 11 (odds ratio, 15.65; p = 0.022). Rebleeding rate after successful initial hemostasis with SB tube was 22.0%, and esophageal rupture occurred in 6.1%. Mortality within 30 days was 42.4%, and the related independent factors with mortality were failure of initial hemostasis with SB tube (hazard ratio, 6.24; p < 0.001) and endotracheal intubation before SB tube (hazard ratio, 2.81; p = 0.018).
Conclusions: Since the era of endoscopic band ligation, SB tube might be a beneficial option as a temporary salvage treatment for uncontrolled variceal hemorrhage. However, rescue therapy had a high incidence of fatal complication and rebleeding.
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KEYWORD
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Variceal hemorrhage, Sengstaken-Blakemore tube, Mortality, Hemostasis
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