Hudhud Dania, Allaham Haytham, Eniezat Mohammad, Enezate Tariq
Department of Internal Medicine, University of Missouri, Columbia, Missouri, USA.
School of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Heart Asia. 2019 Jun 12;11(2):e011223. doi: 10.1136/heartasia-2019-011223. eCollection 2019.
Oesophageal varices (EV) are one of the complications of liver cirrhosis that carries a risk of rupture and bleeding. The safety of performing transesophageal echocardiography (TEE) in patients with pre-existing EV is not well described in literature. Therefore, this retrospective study has been conducted to evaluate the safety of preforming TEE in this group of patients.
The study population was extracted from the 2016 Nationwide Readmissions Data using International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System for EV, TEE and in-hospital outcomes. Study endpoints included in-hospital all-cause mortality, hospital length of stay, postprocedural gastrointestinal bleeding and oesophageal perforation.
A total of 81 328 discharges with a diagnosis of EV were identified, among which 242 had a TEE performed during the index hospitalisation. Mean age was 58.3 years, 36.6% female. In comparison to the no-TEE group, the TEE group was associated with comparable in-hospital all-cause mortality (7.0% vs 6.7%, p=0.86) and bleeding (0.9% vs 1.1%, p=0.75); however, TEE group was associated with longer hospital stay (14.9 days vs 6.9 days, p<0.01). There were no reported oesophageal perforations.
TEE is not a common procedure performed in patients with pre-existing EV. TEE seems to be a safe diagnostic tool for evaluation of heart diseases in this group of patients.
食管静脉曲张（EV）是肝硬化的并发症之一，存在破裂出血风险。对于已有食管静脉曲张的患者进行经食管超声心动图（TEE）检查的安全性，文献中尚无充分描述。因此，本研究进行了一项回顾性研究，以评估在这组患者中进行TEE检查的安全性。
使用国际疾病分类第十版临床修订本/手术编码系统，从2016年全国再入院数据中提取研究人群，涉及食管静脉曲张、TEE及住院结局。研究终点包括住院期间全因死亡率、住院时间、术后胃肠道出血和食管穿孔。
共识别出81328例诊断为食管静脉曲张的出院病例，其中242例在本次住院期间进行了TEE检查。平均年龄为58.3岁，女性占36.6%。与未进行TEE检查的组相比，TEE组的住院期间全因死亡率（7.0%对6.7%，p = 0.86）和出血率（0.9%对1.1%，p = 0.75）相当；然而，TEE组的住院时间更长（14.9天对6.9天，p < 0.01）。未报告食管穿孔病例。
TEE并非已有食管静脉曲张患者常用的检查。TEE似乎是评估这组患者心脏疾病的一种安全诊断工具。
