Korean J Intern Med.  2018 Jul;33(4):696-704. 10.3904/kjim.2016.339.

Outcomes of patients treated with Sengstaken-Blakemore tube for uncontrolled variceal hemorrhage

• Choi JY
• Jo YW
• Lee SS
• Kim WS
• Oh HW
• Kim CY
• Yun EY
• Kim JJ
• Lee JM
• Kim HJ
• Kim HJ
• Kim TH
• Jung WT
• Lee OJ
• Kim RB

• KMID: 2415996
• DOI: http://doi.org/10.3904/kjim.2016.339

Abstract

BACKGROUND/AIMS
The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment.
METHODS
The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed.
RESULTS
The overall success rate of initial hemostasis with SB tube was 75.8%, and the independent factors associated with hemostasis were non-intubated state before SB tube (odds ratio, 8.50; p = 0.007) and Child-Pugh score < 11 (odds ratio, 15.65; p = 0.022). Rebleeding rate after successful initial hemostasis with SB tube was 22.0%, and esophageal rupture occurred in 6.1%. Mortality within 30 days was 42.4%, and the related independent factors with mortality were failure of initial hemostasis with SB tube (hazard ratio, 6.24; p < 0.001) and endotracheal intubation before SB tube (hazard ratio, 2.81; p = 0.018).
CONCLUSIONS
Since the era of endoscopic band ligation, SB tube might be a beneficial option as a temporary salvage treatment for uncontrolled variceal hemorrhage. However, rescue therapy had a high incidence of fatal complication and rebleeding.

Keyword

Variceal hemorrhage; Sengstaken-Blakemore tube; Mortality; Hemostasis

MeSH Terms

Hemodynamics
Hemorrhage*
Hemostasis
Humans
Incidence
Intubation, Intratracheal
Ligation
Mortality
Retrospective Studies
Rupture
Salvage Therapy