Cost-effectiveness of screening, surveillance, and primary prophylaxis strategies for esophageal varices
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Endoscopic screening for esophageal varices in cirrhosis: Is it ever cost effective?
Current guidelines for the management of patients with compensated cirrhosis recommend universal screening endoscopy followed by prophylactic beta-blocker therapy to prevent initial hemorrhage in those found to have esophageal varices. However, the cost-effectiveness of this recommendation has not been established. Our objective was to determine whether screening endoscopy is cost-effective com...
متن کاملEndoscopic screening for varices in cirrhosis: findings, implications, and outcomes.
At least two thirds of cirrhotic patients develop esophageal varices during their lifetime. Severe upper gastrointestinal (UGI) bleeding as a complication of portal hypertension develops in about 30%-40% of cirrhotics. Despite significant improvements in the early diagnosis and treatment of esophagogastric variceal hemorrhage, the mortality rate of first variceal hemorrhage remains high (20%-35...
متن کاملEmpiric beta-blockers for the prophylaxis of variceal hemorrhage: cost effective or clinically applicable?
Current guidelines advocate the use of screening endoscopy in patients with cirrhosis to identify those who could benefit from prophylactic therapy to decrease the incidence of initial variceal hemorrhage.1,2 The decision analysis performed by Spiegel et al. reported in this issue of HEPATOLOGY challenges this practice and illustrates the potential benefit of empiric -blockers for all patients ...
متن کاملPrimary prophylaxis of variceal bleeding in cirrhosis: a cost-effectiveness analysis.
BACKGROUND & AIMS Prophylaxis against the first variceal bleeding has been proposed to reduce morbidity and mortality in cirrhotic patients. No previous information is available regarding the cost-effectiveness of prophylaxis. The aim of this study was to compare the cost-effectiveness of variceal bleeding prophylaxis with propranolol, sclerotherapy, and shunt surgery in cirrhotic patients stra...
متن کامل[Current therapy of esophageal varices hemorrhage].
Acute bleeding from esophageal varices is a medical emergency. It requires a structured therapeutic strategy which is adapted to the local resources. The primary goal is to stop bleeding, preferably by endoscopic sclerotherapy or ligation. In situations where endoscopic intervention is not possible as a first-line treatment, therapy with balloon tamponade or vasoactive drugs (terlipressin or oc...
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تاریخ انتشار 2017