Complications And Prognosis Of Endoscopic Treatment Of Esophagogastric Variceal Bleeding With Prophylactic Endotracheal Intubation

Background: Acute esophagogastric variceal bleeding(EVB)is one of the main causes of cirrhosis-related death,for which endoscopic therapy is the first-line choice.However,whether of prophylactic endotracheal intubation(PEI)before endoscopic surgery can benefit patients is in debate.Our study explores the clinical value of PEI in the endoscopic treatment of EVB,in order to provide an effective and standardized clinical path and a safer diagnosis and treatment process of EVB.Methods: A total of 119 cases of EVB confirmed by endoscopy at the Second Affiliated Hospital of Chongqing Medical University from 2019 to 2020 was collected,with or without PEI.Propensity score matching(PSM)was applied to reduce the bias between the two groups.The rebleeding rate and the in-hospital mortality rate after endoscopic surgery is the primary endpoint between the PEI group and the non-PEI group.Secondary endpoints include the several adverse events occuring within 48 hours after surgery.Meantime,the total length of hospital stay and total cost were calculated.The mortality and rebleeding rate were followed up for 6 weeks.Results: Although there was no significant difference in hospitalized rebleeding rate and mortality between the two groups(P>0.05)before PSM,however,after PSM,the rebleeding rate within 24 hours after surgery in the PEI group was significantly lower(P=0.025).Secondary endpoints: the PEI group had longer ICU hospital stay time(P<0.001)and higher cost(46277 versus39499 RMB,P=0.020).The non-PEI group had a slightly lower survival rate,though with no statistical difference(P=0.425).Conclusion: Our study shows that PEI before endoscopic surgery may reduce the incidence of rebleeding within 24 hours after surgery and the short-term survival.