PMID: 9537847Apr 16, 1998Paper

Analysis of the treatment effect on recurrent bleeding and death in patients with cirrhosis and esophageal varices: multistage competing-risks model compared to conventional methods. The Copenhagen Esophageal Varices Sclerotherapy Project

Journal of Hepatology
B L Thomsen, T I Sørensen

Abstract

Multiple recurrences of bleeding with high mortality in cirrhosis with esophageal varices have been inadequately analyzed in previous trials. We propose analysis by the multistage competing-risks model, specifying the effect on overall mortality as an effect on mortality during bleeding, rate of cessation of bleeding, mortality rate without bleeding, and rate of rebleeding. The Copenhagen Esophageal Varices Project enrolled patients after first bleeding and randomized 94 to usual treatment and 93 to sclerotherapy as supplement. During 9-52 months of follow-up, rebleeding occurred in 49 and 42, and death in 68 and 60 patients, respectively. The proportional hazards regression model (Cox model) was used for reanalysis both by the multistage competing-risks model and by conventional analysis for overall mortality and rate of first rebleeding. In the multistage model, time zero was at entry to any new disease stage, of which the first four were analyzed - two bleeding stages and two bleeding-free stages. The conventional analysis showed a reduction of overall mortality rate in the sclerotherapy group of borderline significance, but no effect on rate of rebleeding. The multistage model indicated that sclerotherapy reduced the rate o...Continue Reading

References

Jun 1, 1987·Endodontics & Dental Traumatology·F M AndreasenP K Andersen
Dec 20, 1984·The New England Journal of Medicine·UNKNOWN Copenhagen Esophageal Varices Sclerotherapy Project
Jul 1, 1995·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·G D'AmicoJ Bosch
Sep 1, 1996·Journal of Hepatology·R de Franchis

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Citations

Mar 1, 2000·Statistics in Medicine·P K AndersenT I Sorensen
Jul 6, 2004·The American Journal of Gastroenterology·Joel H RubensteinJohn M Inadomi
Apr 11, 2021·The Cochrane Database of Systematic Reviews·Danielle RobertsKurinchi Selvan Gurusamy

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