{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:58:29Z","timestamp":1777355909593,"version":"3.51.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":6087,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,1]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Esophageal variceal hemorrhage (EVH) is a serious and expensive sequela of chronic liver disease, leading to increased utilization of resources. Today, endoscopic sclerotherapy (ES) and endoscopic ligation (EL) are the accepted, community standards of endoscopic treatment of patients with EVH. However, there are no published studies comparing the economic costs of treating EVH using these interventions. As part of a prospective, randomized trial comparing ES and EL for the treatment of EVH, we estimated the direct costs of health care utilization and cost\u2013effectiveness for the prevention of variceal rebleeding and patient survival at 1\u2013year follow\u2013up. Treatment groups were similar in incidence of variceal rebleeding (41.9% vs. 42.9%), variceal obliteration (41.9% vs. 40.0%), hospital days, blood transfusions, shunt requirements, and survival (71.0% vs. 60.0%). There were significantly more treatment failures for active bleeding using EL (42% vs. 0%; <jats:italic toggle=\"yes\">P<\/jats:italic> = .027) and esophageal stricture formation in the ES\u2013treated patients (19.4% vs. 2.9%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.03). Median total direct cost outcomes were similar between groups (EL = $9,696 and ES = $13,197; <jats:italic toggle=\"yes\">P<\/jats:italic> = .46). EL and ES had similar cost\/variceal rebleeding prevented ($28,678 vs. $29,093) and cost\/survival ($27,313 vs. $23,804). In the subgroup of active bleeders, ES had a substantially lower cost\/survival ($28,523 vs. $51,696). We conclude that resource utilization was similar between treatment groups and that the choice of endoscopic therapy for EVH must still rely on clinical grounds. Further studies comparing costs and resource utilization in this patient population are needed.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.510290141","type":"journal-article","created":{"date-parts":[[2004,7,27]],"date-time":"2004-07-27T23:36:12Z","timestamp":1090971372000},"page":"44-50","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":52,"title":["The Economic Impact of Esophageal Variceal Hemorrhage: Cost\u2013Effectiveness Implications of Endoscopic Therapy"],"prefix":"10.1097","volume":"29","author":[{"given":"Ian M.","family":"Gralnek","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis M.","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas O.","family":"Kovacs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rome","family":"Jutabha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo A.","family":"Machicado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Gornbein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy","family":"King","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susie","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Ellen","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"10.1002\/hep.510290141-BIB1","first-page":"181","volume-title":"Gastrointestinal Emergencies","author":"Kovacs","year":"1997","unstructured":"Therapeutic endoscopy for upper gastrointestinal bleeding. In: eds. Gastrointestinal Emergencies. 2nd ed. Baltimore: Williams and Wilkins. 1997;181-198."},{"key":"10.1002\/hep.510290141-BIB2","first-page":"274","volume":"155","author":"Laine","year":"1991","journal-title":"West J Med"},{"key":"10.1002\/hep.510290141-BIB3","first-page":"693","volume":"88","author":"O'Donnell","year":"1980","journal-title":"Surgery"},{"key":"10.1002\/hep.510290141-BIB4","series-title":"NIH Publicati","first-page":"3","volume-title":"Digestive diseases in the United States: epidemiology and impact. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases","author":"Everhart","year":"1994","unstructured":"Overview. In: ed. Digestive diseases in the United States: epidemiology and impact. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 1994, NIH Publication no. 94-1447. 3-53."},{"key":"10.1002\/hep.510290141-BIB5","series-title":"NIH Publicati","first-page":"57","volume-title":"Digestive diseases in the United States: epidemiology and impact. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases","author":"Brown","year":"1994","unstructured":"Cost of digestive diseases in the United States. In: ed. Digestive diseases in the United States: epidemiology and impact. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 1994, NIH Publication no. 94-1447. 57-82."},{"key":"10.1002\/hep.510290141-BIB6","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S0025-7125(05)70479-X","volume":"80","author":"Jutabha","year":"1996","journal-title":"Med Clin North Am"},{"key":"10.1002\/hep.510290141-BIB7","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.1056\/NEJM199206043262304","volume":"326","author":"Stiegmann","year":"1992","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.510290141-BIB8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.7326\/0003-4819-119-1-199307010-00001","volume":"119","author":"Laine","year":"1993","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.510290141-BIB9","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/0140-6736(93)92812-8","volume":"342","author":"Gimson","year":"1993","journal-title":"Lancet"},{"key":"10.1002\/hep.510290141-BIB10","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0016-5107(93)70049-8","volume":"39","author":"Young","year":"1993","journal-title":"Gastrointest Endosc"},{"key":"10.1002\/hep.510290141-BIB11","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/S0016-5107(93)70050-4","volume":"39","author":"Hashizume","year":"1993","journal-title":"Gastrointest Endosc"},{"key":"10.1002\/hep.510290141-BIB12","first-page":"1517","volume":"21","author":"Hou","year":"1995","journal-title":"Hepatology"},{"key":"10.1002\/hep.510290141-BIB13","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1002\/hep.1840220215","volume":"22","author":"Lo","year":"1995","journal-title":"Hepatology"},{"key":"10.1002\/hep.510290141-BIB14","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1002\/hep.510250509","volume":"25","author":"Lo","year":"1997","journal-title":"Hepatology"},{"key":"10.1002\/hep.510290141-BIB15","doi-asserted-by":"crossref","first-page":"280","DOI":"10.7326\/0003-4819-123-4-199508150-00007","volume":"123","author":"Laine","year":"1995","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.510290141-BIB16","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1002\/hep.1840220145","volume":"22","author":"D'Amico","year":"1995","journal-title":"Hepatology"},{"key":"10.1002\/hep.510290141-BIB17","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1111\/j.1445-2197.1978.tb07295.x","volume":"48","author":"Stephen","year":"1978","journal-title":"Aust N Z J Surg"},{"key":"10.1002\/hep.510290141-BIB18","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1001\/archsurg.1983.01390040086018","volume":"118","author":"Chung","year":"1983","journal-title":"Arch Surg"},{"key":"10.1002\/hep.510290141-BIB19","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1056\/NEJM198412203112501","volume":"311","author":"Cello","year":"1984","journal-title":"N Engl J Med"},{"key":"10.1002\/hep.510290141-BIB20","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1017\/S026646230001120X","volume":"3","author":"Sasaki","year":"1987","journal-title":"Int J Technol Assess Health Care"},{"key":"10.1002\/hep.510290141-BIB21","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1136\/gut.33.11.1553","volume":"33","author":"Triger","year":"1992","journal-title":"Gut"},{"key":"10.1002\/hep.510290141-BIB22","doi-asserted-by":"crossref","first-page":"377","DOI":"10.3109\/00365529509093294","volume":"30","author":"McCormick","year":"1995","journal-title":"Scand J Gastroenterol"},{"key":"10.1002\/hep.510290141-BIB23","doi-asserted-by":"crossref","first-page":"206a","DOI":"10.1016\/S0016-5107(96)80207-0","volume":"43","author":"Pasha","year":"1996","journal-title":"Gastrointest Endosc"},{"key":"10.1002\/hep.510290141-BIB24","first-page":"4","volume-title":"Current Topics in Gastroenterology and Hepatology","author":"Jensen","year":"1990","unstructured":"New developments in the diagnosis and treatment of severe upper gastrointestinal bleeding. Gastrointestinal emergencies. In: eds. Current Topics in Gastroenterology and Hepatology. Stuttgart: Georg Thieme Verlag. 1990;4-22."},{"key":"10.1002\/hep.510290141-BIB25","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/S0002-9610(05)80602-6","volume":"159","author":"Stiegmann","year":"1990","journal-title":"Am J Surg"},{"key":"10.1002\/hep.510290141-BIB26","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S1089-3261(05)70254-3","volume":"1","author":"Gralnek","year":"1997","journal-title":"Clin Liver Dis"},{"key":"10.1002\/hep.510290141-BIB27","doi-asserted-by":"crossref","first-page":"2879","DOI":"10.1001\/jama.1989.03430200123038","volume":"262","author":"Eisenberg","year":"1989","journal-title":"JAMA"},{"key":"10.1002\/hep.510290141-BIB28","volume-title":"Methods for the Economic Evaluation of Health Care Programmes","author":"Drummond","year":"1987","unstructured":"Methods for the Economic Evaluation of Health Care Programmes. Oxford: Oxford University Press, 1987."},{"key":"10.1002\/hep.510290141-BIB29","doi-asserted-by":"crossref","first-page":"858","DOI":"10.7326\/0003-4819-126-11-199706010-00002","volume":"126","author":"Cello","year":"1997","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.510290141-BIB30","first-page":"1081","volume":"92","author":"Grace","year":"1997","journal-title":"Am J Gastroenterol"},{"key":"10.1002\/hep.510290141-BIB31","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/S0016-5107(97)70218-9","volume":"46","author":"Laine","year":"1997","journal-title":"Gastrointest Endosc"},{"key":"10.1002\/hep.510290141-BIB32","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/0016-5085(95)90297-X","volume":"109","author":"Sandler","year":"1995","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.510290141-BIB33","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0016-5107(97)70056-7","volume":"46","author":"Gralnek","year":"1997","journal-title":"Gastrointest Endosc"},{"key":"10.1002\/hep.510290141-BIB34","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1111\/j.1572-0241.1998.00590.x","volume":"93","author":"Gralnek","year":"1998","journal-title":"Am J Gastroenterol"},{"key":"10.1002\/hep.510290141-BIB35","doi-asserted-by":"crossref","first-page":"102","DOI":"10.7326\/0003-4819-96-1-102","volume":"96","author":"Finkler","year":"1982","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.510290141-BIB36","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1016\/0016-5085(81)90144-X","volume":"80","author":"Graham","year":"1981","journal-title":"Gastroenterology"}],"container-title":["Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhep.510290141","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01515467-199901000-00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T11:26:39Z","timestamp":1733052399000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01515467-199901000-00008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,1]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1999]]}},"URL":"https:\/\/doi.org\/10.1002\/hep.510290141","relation":{},"ISSN":["0270-9139"],"issn-type":[{"value":"0270-9139","type":"print"}],"subject":[],"published":{"date-parts":[[1999,1]]}}}