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Prevención secundaria de la hemorragia por várices en adultos con hemorragia previa por várices esofágicas debido a cirrosis hepática descompensada: un metanálisis en red
Maria Corina Plaz Torres, Lawrence MJ Best, Suzanne C Freeman, Danielle Roberts, Nicola J Cooper, Alex J Sutton, Davide Roccarina, Amine Benmassaoud, Laura Iogna Prat, Norman R Williams, Mario Csenar, Dominic Fritche, Tanjia Begum, Sivapatham Arunan, Maxine Tapp, Elisabeth Jane Milne, Chavdar S Pavlov, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy | 30 marzo 2021

Topics

Temas

Comparison 1 TIPS versus paracentesis ‐ mortality, Outcome 1 30‐day mortality.
Figuras y tablas -
Analysis 1.1

Comparison 1 TIPS versus paracentesis ‐ mortality, Outcome 1 30‐day mortality.

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Comparison 2 TIPS versus paracentesis ‐ mortality, Outcome 1 24‐month mortality.
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Analysis 2.1

Comparison 2 TIPS versus paracentesis ‐ mortality, Outcome 1 24‐month mortality.

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Comparison 2 TIPS versus paracentesis ‐ mortality, Outcome 2 24 months mortality ‐ furosemide 160 mg/d.
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Analysis 2.2

Comparison 2 TIPS versus paracentesis ‐ mortality, Outcome 2 24 months mortality ‐ furosemide 160 mg/d.

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Comparison 2 TIPS versus paracentesis ‐ mortality, Outcome 3 24 month mortality ‐ spironolactone 400mg/d.
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Analysis 2.3

Comparison 2 TIPS versus paracentesis ‐ mortality, Outcome 3 24 month mortality ‐ spironolactone 400mg/d.

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Comparison 3 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 1 3‐months ascites re‐accumulation.
Figuras y tablas -
Analysis 3.1

Comparison 3 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 1 3‐months ascites re‐accumulation.

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Comparison 4 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 1 12‐month ascites re‐accumulation.
Figuras y tablas -
Analysis 4.1

Comparison 4 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 1 12‐month ascites re‐accumulation.

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Comparison 4 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 2 12 month ascites re‐accumulation ‐ furosemide 160mg/d.
Figuras y tablas -
Analysis 4.2

Comparison 4 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 2 12 month ascites re‐accumulation ‐ furosemide 160mg/d.

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Comparison 4 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 3 12 month ascites re‐accumulation ‐ spironolactone 400mg/d.
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Analysis 4.3

Comparison 4 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 3 12 month ascites re‐accumulation ‐ spironolactone 400mg/d.

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Comparison 4 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 4 12 month re‐accumulation ‐ sodium < 2g/d.
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Analysis 4.4

Comparison 4 TIPS versus paracentesis ‐ ascites re‐accumulation, Outcome 4 12 month re‐accumulation ‐ sodium < 2g/d.

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Comparison 5 TIPS versus paracentesis ‐ complications, Outcome 1 Gastrointestinal bleeding.
Figuras y tablas -
Analysis 5.1

Comparison 5 TIPS versus paracentesis ‐ complications, Outcome 1 Gastrointestinal bleeding.

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Comparison 5 TIPS versus paracentesis ‐ complications, Outcome 2 Septecemia/infection.
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Analysis 5.2

Comparison 5 TIPS versus paracentesis ‐ complications, Outcome 2 Septecemia/infection.

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Comparison 5 TIPS versus paracentesis ‐ complications, Outcome 3 Acute renal failure.
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Analysis 5.3

Comparison 5 TIPS versus paracentesis ‐ complications, Outcome 3 Acute renal failure.

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Comparison 5 TIPS versus paracentesis ‐ complications, Outcome 4 Hepatic encephalopathy.
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Analysis 5.4

Comparison 5 TIPS versus paracentesis ‐ complications, Outcome 4 Hepatic encephalopathy.

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Comparison 1. TIPS versus paracentesis ‐ mortality

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 30‐day mortality Show forest plot

2

85

Odds Ratio (M‐H, Random, 95% CI)

1.00 [0.10, 10.06]
Figuras y tablas -
Comparison 1. TIPS versus paracentesis ‐ mortality
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Comparison 2. TIPS versus paracentesis ‐ mortality

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 24‐month mortality Show forest plot

5

330

Odds Ratio (M‐H, Random, 95% CI)

1.29 [0.65, 2.56]

2 24 months mortality ‐ furosemide 160 mg/d Show forest plot

3

245

Odds Ratio (M‐H, Random, 95% CI)

1.47 [0.85, 2.56]

3 24 month mortality ‐ spironolactone 400mg/d Show forest plot

3

239

Odds Ratio (M‐H, Random, 95% CI)

0.93 [0.42, 2.02]
Figuras y tablas -
Comparison 2. TIPS versus paracentesis ‐ mortality
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Comparison 3. TIPS versus paracentesis ‐ ascites re‐accumulation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 3‐months ascites re‐accumulation Show forest plot

3

140

Odds Ratio (M‐H, Random, 95% CI)

0.07 [0.03, 0.18]
Figuras y tablas -
Comparison 3. TIPS versus paracentesis ‐ ascites re‐accumulation
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Comparison 4. TIPS versus paracentesis ‐ ascites re‐accumulation

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 12‐month ascites re‐accumulation Show forest plot

4

270

Odds Ratio (M‐H, Random, 95% CI)

0.15 [0.08, 0.28]

2 12 month ascites re‐accumulation ‐ furosemide 160mg/d Show forest plot

2

179

Odds Ratio (M‐H, Random, 95% CI)

0.12 [0.06, 0.27]

3 12 month ascites re‐accumulation ‐ spironolactone 400mg/d Show forest plot

2

179

Odds Ratio (M‐H, Random, 95% CI)

0.12 [0.06, 0.27]

4 12 month re‐accumulation ‐ sodium < 2g/d Show forest plot

4

270

Odds Ratio (M‐H, Random, 95% CI)

0.15 [0.08, 0.28]
Figuras y tablas -
Comparison 4. TIPS versus paracentesis ‐ ascites re‐accumulation
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Comparison 5. TIPS versus paracentesis ‐ complications

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Gastrointestinal bleeding Show forest plot

3

245

Odds Ratio (M‐H, Random, 95% CI)

0.75 [0.37, 1.54]

2 Septecemia/infection Show forest plot

2

179

Odds Ratio (M‐H, Random, 95% CI)

1.05 [0.22, 4.94]

3 Acute renal failure Show forest plot

2

179

Odds Ratio (M‐H, Random, 95% CI)

0.64 [0.15, 2.72]

4 Hepatic encephalopathy Show forest plot

5

330

Odds Ratio (M‐H, Random, 95% CI)

2.24 [1.39, 3.60]
Figuras y tablas -
Comparison 5. TIPS versus paracentesis ‐ complications
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