METHODS: Overall, 258 patients who underwent initial BRTO for GV treatment between January 2004 and May 2019 at 12 institutions were retrospectively registered.
RESULTS: Technical success was achieved in 235 patients (91.1%). Based on the exclusion criteria, 37 patients were excluded, and 198 were evaluated. The cumulative worsening rates of EVs at 1, 2, and 3 years were 39.0%, 59.4%, and 68.4%, respectively. In the univariate Cox proportional hazards model, sex, EV size, history of EV treatment, left gastric vein dilatation, platelet count, aspartate transaminase (AST), alanine aminotransferase (ALT), total bilirubin, albumin, albumin-bilirubin score, prothrombin time-international normalized ratio, fibrosis-4 index, AST to platelet ratio index, and spleen width were significantly associated with worsening of EV after BRTO. Multivariate analysis showed that sex (adjusted hazard ratio [aHR] 1.72; 95% confidence interval [CI] 1.03-2.86; P = 0.04), left gastric vein dilatation (aHR 1.90; 95% CI 1.17-3.10; P = 0.01), ALT (aHR 1.01; 95% CI 1.00-1.03; P = 0.02), albumin (aHR 0.61; 95% CI 0.43-0.87; P < 0.01), and spleen width (aHR 1.02; 95% CI 1.01-1.03; P < 0.01) were independent risk factors for worsening of EV after BRTO. Patients with EV worsening within 1 year after BRTO had a significantly worse prognosis than the other patients (P = 0.007).
CONCLUSIONS: Early worsening of EV after BRTO was associated with poor prognosis after BRTO.
方法:总的来说,回顾性登记了在2004年1月至2019年5月期间在12个机构接受GV初始BRTO治疗的258例患者。
结果:235例患者(91.1%)获得了技术成功。根据排除标准,37例患者被排除在外,对198人进行了评估。1年、2年和3年电动汽车的累积恶化率为39.0%,59.4%,和68.4%,分别。在单变量Cox比例风险模型中,性别,EV尺寸,EV治疗史,胃左静脉扩张,血小板计数,天冬氨酸转氨酶(AST),丙氨酸氨基转移酶(ALT),总胆红素,白蛋白,白蛋白-胆红素评分,凝血酶原时间-国际标准化比率,纤维化-4指数,AST与血小板比值指数,脾脏宽度与BRTO后EV恶化显著相关。多变量分析显示,性别(调整后的风险比[aHR]1.72;95%置信区间[CI]1.03-2.86;P=0.04),胃左静脉扩张(aHR1.90;95%CI1.17-3.10;P=0.01),ALT(aHR1.01;95%CI1.00-1.03;P=0.02),白蛋白(AHR0.61;95%CI0.43-0.87;P<0.01),脾脏宽度(aHR1.02;95%CI1.01-1.03;P<0.01)是BRTO后EV恶化的独立危险因素。BRTO后1年内EV恶化的患者的预后明显比其他患者差(P=0.007)。
结论:BRTO术后早期EV恶化与BRTO术后不良预后相关。