Gastrointestinal varices epidemiology and demographics: Difference between revisions
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==Overview== | ==Overview== | ||
Gastroesophageal varices are present in approximately 50,000 per 100,000 patients with [[cirrhosis]], depending upon the clinical stage of the disease. The annual [[incidence]] of gastrointestinal varices ranges from a low of 7,000 per 100,000 individuals to a high of 8,000 per 100,000 individuals. Variceal [[hemorrhage]] occurs at a rate of around 10%-15% per year and depends on the severity of liver disease, size of varices, and presence of red wale marks (areas of thinning of the variceal wall). | |||
==Epidemiology and | ==Epidemiology and Demographics== | ||
===Prevalence=== | ===Prevalence=== | ||
* Gastroesophageal varices are present in approximately | * Gastroesophageal varices are present in approximately 50,000 per 100,000 patients with [[cirrhosis]], depending upon the clinical stage of the disease<ref name="urlPortal hypertension and variceal bleeding: An AASLD single topic symposium - Grace - 2003 - Hepatology - Wiley Online Library">{{cite web |url=http://onlinelibrary.wiley.com/doi/10.1002/hep.510280339/pdf |title=Portal hypertension and variceal bleeding: An AASLD single topic symposium - Grace - 2003 - Hepatology - Wiley Online Library |format= |work= |accessdate=}}</ref> | ||
* In patients with compensated cirrhosis, gastroesophageal varices are present in | * In patients with compensated [[cirrhosis]], gastroesophageal varices are present in 30,000 - 40,000 patients per 100,000 patients, whereas they can be present in up to 85,000 per 100,000 patients with decompensated [[cirrhosis]]<ref name="pmid17185084">{{cite journal |vauthors=Kovalak M, Lake J, Mattek N, Eisen G, Lieberman D, Zaman A |title=Endoscopic screening for varices in cirrhotic patients: data from a national endoscopic database |journal=Gastrointest. Endosc. |volume=65 |issue=1 |pages=82–8 |year=2007 |pmid=17185084 |doi=10.1016/j.gie.2006.08.023 |url=}}</ref> | ||
===Incidence=== | ===Incidence=== | ||
* The annual incidence of gastrointestinal varices ranges from a low of | * The annual [[incidence]] of gastrointestinal varices ranges from a low of 7,000 per 100,000 individuals to a high of 8,000 per 100,000 individuals<ref name="GroszmannGarcia-Tsao2005">{{cite journal|last1=Groszmann|first1=Roberto J.|last2=Garcia-Tsao|first2=Guadalupe|last3=Bosch|first3=Jaime|last4=Grace|first4=Norman D.|last5=Burroughs|first5=Andrew K.|last6=Planas|first6=Ramon|last7=Escorsell|first7=Angels|last8=Garcia-Pagan|first8=Juan Carlos|last9=Patch|first9=David|last10=Matloff|first10=Daniel S.|last11=Gao|first11=Hong|last12=Makuch|first12=Robert|title=Beta-Blockers to Prevent Gastroesophageal Varices in Patients with Cirrhosis|journal=New England Journal of Medicine|volume=353|issue=21|year=2005|pages=2254–2261|issn=0028-4793|doi=10.1056/NEJMoa044456}}</ref> | ||
* Progression from small varices to large varices occurs at a rate of 10 - 12 % | * Progression from small varices to large varices occurs at a rate of 10%- 12% annually<ref name="pmid12586291">{{cite journal |vauthors=Merli M, Nicolini G, Angeloni S, Rinaldi V, De Santis A, Merkel C, Attili AF, Riggio O |title=Incidence and natural history of small esophageal varices in cirrhotic patients |journal=J. Hepatol. |volume=38 |issue=3 |pages=266–72 |year=2003 |pmid=12586291 |doi= |url=}}</ref> | ||
* Variceal [[hemorrhage]] occurs at a rate of around 10%-15% per year and depends on the severity of liver disease, size of varices, and presence of red wale marks (areas of thinning of the variceal wall)<ref name="pmid3262200">{{cite journal |vauthors= |title=Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study |journal=N. Engl. J. Med. |volume=319 |issue=15 |pages=983–9 |year=1988 |pmid=3262200 |doi=10.1056/NEJM198810133191505 |url=}}</ref><ref name="pmid10643630">{{cite journal |vauthors=D'Amico G, Pagliaro L, Bosch J |title=Pharmacological treatment of portal hypertension: an evidence-based approach |journal=Semin. Liver Dis. |volume=19 |issue=4 |pages=475–505 |year=1999 |pmid=10643630 |doi=10.1055/s-2007-1007133 |url=}}</ref> | |||
===Age=== | ===Age=== | ||
* African Americans are significantly more likely to be older than Caucasians or Hispanics, when patients with [[cirrhosis]] are studied<ref name="pmid163230962">{{cite journal |vauthors=Pearlman BL |title=Hepatitis C virus infection in African Americans |journal=Clin. Infect. Dis. |volume=42 |issue=1 |pages=82–91 |year=2006 |pmid=16323096 |doi=10.1086/498512 |url=}}</ref> | |||
* White patients have equal proportions of [[Cirrhosis|cirrhotics]] in the younger and older age groups<ref name="pmid25203153">{{cite journal |vauthors=Sajja KC, Mohan DP, Rockey DC |title=Age and ethnicity in cirrhosis |journal=J. Investig. Med. |volume=62 |issue=7 |pages=920–6 |year=2014 |pmid=25203153 |pmc=4172494 |doi=10.1097/JIM.0000000000000106 |url=}}</ref> | |||
===Race=== | ===Race=== | ||
* Hispanic and White patients were more likely to have [[cirrhosis]] due to alcohol than African American patients<ref name="pmid252031532">{{cite journal |vauthors=Sajja KC, Mohan DP, Rockey DC |title=Age and ethnicity in cirrhosis |journal=J. Investig. Med. |volume=62 |issue=7 |pages=920–6 |year=2014 |pmid=25203153 |pmc=4172494 |doi=10.1097/JIM.0000000000000106 |url=}}</ref> | |||
=== | * The prevalence of HCV appears to be the greatest in African American patients, compared to all other ethnic groups in the United States<ref name="pmid16323096">{{cite journal |vauthors=Pearlman BL |title=Hepatitis C virus infection in African Americans |journal=Clin. Infect. Dis. |volume=42 |issue=1 |pages=82–91 |year=2006 |pmid=16323096 |doi=10.1086/498512 |url=}}</ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} |
Latest revision as of 19:45, 24 January 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Gastroesophageal varices are present in approximately 50,000 per 100,000 patients with cirrhosis, depending upon the clinical stage of the disease. The annual incidence of gastrointestinal varices ranges from a low of 7,000 per 100,000 individuals to a high of 8,000 per 100,000 individuals. Variceal hemorrhage occurs at a rate of around 10%-15% per year and depends on the severity of liver disease, size of varices, and presence of red wale marks (areas of thinning of the variceal wall).
Epidemiology and Demographics
Prevalence
- Gastroesophageal varices are present in approximately 50,000 per 100,000 patients with cirrhosis, depending upon the clinical stage of the disease[1]
- In patients with compensated cirrhosis, gastroesophageal varices are present in 30,000 - 40,000 patients per 100,000 patients, whereas they can be present in up to 85,000 per 100,000 patients with decompensated cirrhosis[2]
Incidence
- The annual incidence of gastrointestinal varices ranges from a low of 7,000 per 100,000 individuals to a high of 8,000 per 100,000 individuals[3]
- Progression from small varices to large varices occurs at a rate of 10%- 12% annually[4]
- Variceal hemorrhage occurs at a rate of around 10%-15% per year and depends on the severity of liver disease, size of varices, and presence of red wale marks (areas of thinning of the variceal wall)[5][6]
Age
- African Americans are significantly more likely to be older than Caucasians or Hispanics, when patients with cirrhosis are studied[7]
- White patients have equal proportions of cirrhotics in the younger and older age groups[8]
Race
- Hispanic and White patients were more likely to have cirrhosis due to alcohol than African American patients[9]
- The prevalence of HCV appears to be the greatest in African American patients, compared to all other ethnic groups in the United States[10]
References
- ↑ "Portal hypertension and variceal bleeding: An AASLD single topic symposium - Grace - 2003 - Hepatology - Wiley Online Library".
- ↑ Kovalak M, Lake J, Mattek N, Eisen G, Lieberman D, Zaman A (2007). "Endoscopic screening for varices in cirrhotic patients: data from a national endoscopic database". Gastrointest. Endosc. 65 (1): 82–8. doi:10.1016/j.gie.2006.08.023. PMID 17185084.
- ↑ Groszmann, Roberto J.; Garcia-Tsao, Guadalupe; Bosch, Jaime; Grace, Norman D.; Burroughs, Andrew K.; Planas, Ramon; Escorsell, Angels; Garcia-Pagan, Juan Carlos; Patch, David; Matloff, Daniel S.; Gao, Hong; Makuch, Robert (2005). "Beta-Blockers to Prevent Gastroesophageal Varices in Patients with Cirrhosis". New England Journal of Medicine. 353 (21): 2254–2261. doi:10.1056/NEJMoa044456. ISSN 0028-4793.
- ↑ Merli M, Nicolini G, Angeloni S, Rinaldi V, De Santis A, Merkel C, Attili AF, Riggio O (2003). "Incidence and natural history of small esophageal varices in cirrhotic patients". J. Hepatol. 38 (3): 266–72. PMID 12586291.
- ↑ "Prediction of the first variceal hemorrhage in patients with cirrhosis of the liver and esophageal varices. A prospective multicenter study". N. Engl. J. Med. 319 (15): 983–9. 1988. doi:10.1056/NEJM198810133191505. PMID 3262200.
- ↑ D'Amico G, Pagliaro L, Bosch J (1999). "Pharmacological treatment of portal hypertension: an evidence-based approach". Semin. Liver Dis. 19 (4): 475–505. doi:10.1055/s-2007-1007133. PMID 10643630.
- ↑ Pearlman BL (2006). "Hepatitis C virus infection in African Americans". Clin. Infect. Dis. 42 (1): 82–91. doi:10.1086/498512. PMID 16323096.
- ↑ Sajja KC, Mohan DP, Rockey DC (2014). "Age and ethnicity in cirrhosis". J. Investig. Med. 62 (7): 920–6. doi:10.1097/JIM.0000000000000106. PMC 4172494. PMID 25203153.
- ↑ Sajja KC, Mohan DP, Rockey DC (2014). "Age and ethnicity in cirrhosis". J. Investig. Med. 62 (7): 920–6. doi:10.1097/JIM.0000000000000106. PMC 4172494. PMID 25203153.
- ↑ Pearlman BL (2006). "Hepatitis C virus infection in African Americans". Clin. Infect. Dis. 42 (1): 82–91. doi:10.1086/498512. PMID 16323096.