©The Author(s) 2025.
World J Gastroenterol. Nov 7, 2025; 31(41): 111361
Published online Nov 7, 2025. doi: 10.3748/wjg.v31.i41.111361
Published online Nov 7, 2025. doi: 10.3748/wjg.v31.i41.111361
Table 2 Baseline characteristics and outcomes of acute variceal bleeding patients treated with endoscopic variceal ligation plus pharmacotherapy or preemptive transjugular intrahepatic portosystemic shunt, mean ± SD/n (%)
| Characteristics | High-risk for EVL + PT failure | Low-risk for EVL + PT failure | ||||
| EVL + PT (n = 220) | p-TIPS (n = 704) | P value | EVL + PT (n = 1007) | p-TIPS (n = 1159) | P value | |
| Demographic characteristics | ||||||
| Age (years) | 52.4 ± 10.9 | 52.6 ± 11.7 | 0.167 | 53.3 ± 11.8 | 51.5 ± 12.5 | 0.042 |
| Sex | 0.011 | 0.020 | ||||
| Male | 162 (73.6) | 457 (64.9) | 715 (71.0) | 729 (62.9) | ||
| Female | 58 (26.4) | 247 (35.1) | 292 (29.0) | 430 (37.1) | ||
| Etiology of cirrhosis | 0.072 | 0.005 | ||||
| Chronic HBV infection | 154 (70.0) | 476 (67.6) | 610 (60.6) | 761 (65.7) | ||
| Chronic HCV infection | 6 (2.7) | 35 (5.0) | 73 (7.2) | 100 (8.6) | ||
| Alcohol | 23 (10.5) | 63 (8.9) | 122 (12.1) | 92 (7.9) | ||
| Others | 18 (8.1) | 92 (13.1) | 123 (12.2) | 133 (11.5) | ||
| Cryptogenic | 19 (8.6) | 38 (5.4) | 79 (7.8) | 73 (6.3) | ||
| Medical history | ||||||
| Previous variceal bleeding | 93 (42.3) | 319 (45.3) | 0.537 | 375 (37.2) | 447 (38.6) | 0.618 |
| Location of varices | 0.692 | 0.544 | ||||
| Esophageal varices only | 131 (59.5) | 432 (61.4) | 576 (57.2) | 679 (58.6) | ||
| Esophageal and gastric varices | 89 (40.5) | 272 (38.6) | 431 (42.8) | 480 (41.4) | ||
| Hepatic encephalopathy | 32 (14.5) | 116 (16.4) | 0.236 | 83 (8.2) | 105 (9.1) | 0.280 |
| Ascites | 0.021 | 0.066 | ||||
| Mild | 89 (40.5) | 263 (37.3) | 366 (36.3) | 395 (34.1) | ||
| Moderate | 42 (19.1) | 144 (20.4) | 153 (15.2) | 220 (19.0) | ||
| Massive | 9 (4.1) | 72 (10.2) | 79 (7.8) | 104 (9.0) | ||
| Heart rate at admission (beats/minute) | 84.4 ± 14.4 | 83.1 ± 15.3 | 0.384 | 87.8 ± 16.4 | 86.8 ± 15.7 | 0.033 |
| Systolic blood pressure at admission (mmHg) | 112.0 ± 12.9 | 113.8 ± 17.9 | 0.067 | 117.4 ± 14.5 | 115.8 ± 16.0 | 0.003 |
| Diastolic blood pressure at admission (mmHg) | 67.5 ± 10.8 | 70.6 ± 12.4 | 0.002 | 69.5 ± 9.9 | 68.1 ± 11.5 | 0.042 |
| Laboratory examination | ||||||
| White blood cell (× 109 cell/L) | 8.4 ± 5.9 | 8.0 ± 3.9 | 0.246 | 6.0 ± 3.9 | 6.3 ± 4.4 | 0.095 |
| Red blood cell (× 109 cell/L) | 2.5 ± 0.7 | 2.4 ± 0.6 | 0.387 | 2.8 ± 0.7 | 3.5 ± 7.3 | 0.003 |
| Hemoglobin (g/L) | 75.2 ± 22.8 | 72.6 ± 22.6 | 0.038 | 77.7 ± 22.3 | 82.5 ± 24.9 | < 0.001 |
| Platelet count (× 109/L) | 87.0 ± 57.8 | 86.4 ± 54.3 | 0.888 | 95.0 ± 89.0 | 97.6 ± 86.6 | 0.492 |
| NEC (× 109/L) | 7.6 ± 8.8 | 6.8 ± 5.7 | 0.115 | 5.1 ± 8.4 | 4.7 ± 5.9 | 0.196 |
| AST (U/L) | 124.9 ± 233.5 | 106.1 ± 167.5 | 0.189 | 76.1 ± 493.4 | 50.3 ± 99.0 | 0.082 |
| ALT (U/L) | 62.0 ± 101.9 | 55.6 ± 40.8 | 0.176 | 49.6 ± 214.2 | 34.9 ± 40.8 | 0.022 |
| TBIL (μmol/L) | 104.1 ± 120.8 | 60.2 ± 49.5 | < 0.001 | 23.7 ± 23.8 | 27.3 ± 25.4 | < 0.001 |
| Albumin (g/L) | 25.2 ± 4.6 | 25.6 ± 6.9 | 0.421 | 29.2 ± 5.3 | 32.9 ± 8.7 | < 0.001 |
| INR | 1.6 ± 0.5 | 2.1 ± 1.8 | < 0.001 | 1.4 ± 2.9 | 1.4 ± 1.4 | 0.898 |
| APTT (second) | 49.2 ± 19.1 | 46.2 ± 19.7 | 0.047 | 36.0 ± 14.6 | 35.3 ± 10.9 | 0.203 |
| TT (second) | 21.4 ± 3.8 | 22.1 ± 7.0 | 0.156 | 19.5 ± 3.5 | 19.3 ± 5.4 | 0.315 |
| PT (second) | 18.5 ± 6.7 | 23.9 ± 20.3 | 0.001 | 14.2 ± 3.5 | 15.6 ± 3.4 | < 0.001 |
| Creatinine (μmol/L) | 100 ± 82.9 | 86.8 ± 58.4 | 0.009 | 82.5 ± 70.1 | 73.6 ± 44.1 | < 0.001 |
| Risk stratification index | ||||||
| MELD score (points) | 13.5 ± 4.0 | 15.9 ± 6.5 | 0.002 | 11.2 ± 3.6 | 12.5 ± 3.8 | 0.034 |
| Child-Pugh score (points), median IQR | 7.9 (5.1-10.7) | 8.2 (6.1-10.3) | 0.068 | 7.4 (5.5-9.3) | 7.2 (5.6-8.8) | < 0.001 |
| Child-Pugh class | 0.167 | < 0.001 | ||||
| A (5-6) | 42 (19.2) | 101 (14.4) | 254 (25.2) | 336 (29.0) | ||
| B (7-9) | 131 (59.5) | 424 (60.3) | 567 (56.3) | 719 (62.1) | ||
| C (10-13) | 47 (21.4) | 179 (25.4) | 186 (18.5) | 104 (8.9) | ||
| Early TIPS criteria | < 0.001 | < 0.001 | ||||
| Low risk | 161 (73.2) | 390 (55.4) | 789 (78.4) | 707 (61.0) | ||
| High risk | 59 (26.8) | 314 (44.6) | 218 (21.6) | 452 (39.0) | ||
| Treatment procedure | ||||||
| Initial pharmacological therapy | 0.087 | < 0.001 | ||||
| Octreotide | 283 (28.1) | 314 (27.1) | 31 (14.1) | 140 (19.9) | ||
| Somatostatin | 597 (59.3) | 730 (63.0) | 152 (69.1) | 513 (72.9) | ||
| Terlipressin | 127 (12.6) | 115 (9.9) | 37 (16.8) | 51 (7.2) | ||
| p-TIPS stent diameter | ||||||
| < 8 mm | 137 (19.5) | 61 (5.3) | ||||
| 8 mm | 554 (78.2) | 1025 (88.4) | ||||
| 10 mm | 16 (2.3) | 73 (6.3) | ||||
| Outcome measurements | ||||||
| 6-week treatment failure to control bleeding | 87 (39.6) | 27 (3.8) | < 0.001 | 68 (6.8) | 22 (1.9) | 0.013 |
| ICU requirement | 102 (46.4) | 144 (20.5) | 0.005 | 172 (17.1) | 151 (13.0) | 0.049 |
| 1-year mortality | 82 (37.3) | 103 (14.6) | < 0.001 | 141 (14.0) | 121 (10.4) | 0.036 |
| Treatment-related adverse events | ||||||
| Hepatic encephalopathy | 36 (16.4) | 285 (30.5) | < 0.001 | 150 (14.9) | 314 (27.1) | < 0.001 |
| New or worsening ascites | 12 (5.5) | 10 (1.4) | < 0.001 | 19 (1.9) | 10 (0.9) | < 0.001 |
- Citation: Xiang Y, Yang N, Zheng TL, Huang YF, Liu TY, Ma DQ, Hu SJ, Zhang WH, Xiang HL, Zhang LY, Yuan LL, Wang X, Dang T, Zhang G, Wu B, Peng LJ, Gao M, Xia DL, Liu ZB, Li J, Song Y, Zhou XQ, Qi XS, Zeng J, Tan XY, Deng MM, Fang HM, Qi SL, He S, He YF, Ye B, Wu W, Shao JB, Wei W, Hu JP, Yong X, He CH, Bao JL, Zhang YN, Ji R, Bo Y, Yan W, Li HJ, Li SL, Geng S, Zhao L, Liu B, Qi XL. Development of a deep learning model for guiding treatment decisions of acute variceal bleeding in patients with cirrhosis. World J Gastroenterol 2025; 31(41): 111361
- URL: https://www.wjgnet.com/1007-9327/full/v31/i41/111361.htm
- DOI: https://dx.doi.org/10.3748/wjg.v31.i41.111361