Beta-blockers don't mar acute variceal bleeding prognosis
Andrea Ribeiro de Souza, from the University of Barcelona and Centro de Investigación in Spain, and colleagues examined the effect of being on prophylactic therapy with NSBB on five-day failure (a composite of failure to control bleeding or
early rebleeding within five days, whichever occurs first) and six-week mortality (bleeding-related
mortality) for cirrhotic patients admitted with AVB. Of the 142 patients included in the study, forty-nine were receiving prophylactic therapy with NSBB.
The researchers found that five-day failure occurred in 20 percent of patients overall: 14 and 24 percent in the NSBB and control groups, respectively (P = 0.27). For five-day failure under NSBB, the adjusted odds ratio was 2.46 (95 percent confidence interval, 0.53 to 11.37; P = 0.25). Within six weeks, 19 patients (13 percent) died and two had liver transplantation. The probability of survival at six weeks was 96 and 82 percent in the NSBB and control groups, respectively (P = 0.02). The adjusted odds ratio for six-week mortality was 0.38 (95 percent confidence interval, 0.05 to 2.63; P = 0.32) after adjustment for propensity score and model for end-stage liver disease.
"Our study indicates that being under prophylactic NSBB treatment is not a negative prognostic indicator for the short-term survival of cirrhotic patients admitted with AVB," the authors write.
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