33. Frequency of Rebleeding Between Short Course Terlipressin (24 Hours) and Usual Course (72 Hours) Terlipressin in Adult Cirrhotic Patients Presenting with Acute Variceal Rebleeding
Mehreen Zaman1, Asif Raza Zaidi2, Ali Hyder3, Mahesh Kumar4, Joher Amin2
and Kashif Malik2
ABSTRACT
Objective: To compare frequency of rebleeding between short course terlipressin (24 hours) and usual course (72 hours) terlipressin given as an adjunct to conventional EVBL in adult cirrhotic patients presenting with acute variceal rebleeding.
Study Design:A randomized control trial
Place and Duration of study: This study was conducted at the Department of Gastroenterology, Shaikh Zaid Hospital Lahorefor One Year from July 2016 to June 2017.
Materials and Methods:100 cases were included through Non probability consecutive sampling. Patients were randomized to group A or B using lottery method. Written informed-consent was taken from all included patients. Rebleeding was assessed during 5 days of hospitalization (as per operational definition). All data was entered and analyzed using SPSS version 13.0. Chi-square test was used to compare the significant difference in rebleeding in both groups. A p-value of ≤0.05 was considered significant.
Results: The mean age of the patients was 55.16±5.56 years having 58 (58%) male and 42 (42%) female. Before start of treatment, hematemesis was observed in 45 (90%) randomized to short course which was remained in 5 (10%) patients after treatment. Patients randomized to usual course, hematemesis was observed in 36 (72%) cases which was remained in 4 (8%) patients after treatment. Before start of treatment, melena was observed in 42 (84%) randomized to short course which was remained in 5 (10%) patients after treatment. Patients randomized to usual course, melena was observed in 42 (84%) cases which was remained in 4 (8%) patients after treatment which is highly insignificant. After treatment, rebleeding was observed in 5 (10%) randomized to short course while with usual course, rebleeding was observed in 4 (8%) cases. The difference between both groups was highly insignificant (p>0.05).
Conclusion: It was concluded through results of this study that short course terlipressin is equally effective as usual course. Now we can recommend short course for management of variceal bleed to prevent rebleed instead of usual course.
Key Words: Variceal Bleeding, Rebleed, Endoscopic Band Ligation, Terlipressin, Cirrhosis, Hematemesis, Melena, Hypovolemic Shoc
Citation of articles: Zaman M, Zaidi AR, Hyder A, Kumar M, Amin J, Malik K. Frequency of Rebleeding Between Short Course Terlipressin (24 Hours) and Usual Course (72 Hours) Terlipressin in Adult Cirrhotic Patients Presenting with Acute Variceal Rebleeding. Med Forum 2019;30(2):130-133.