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Most cases require urgent endoscopic intervention due to potentially life\u2010threatening courses. Different endoscopic hemostasis techniques can be used, in particular endoscopic variceal ligation (EVL) and endoscopic sclerotherapy (EST), depending on the bleeding side (esophageal, fundal, and gastric) as well as radiological interventions (e.g., embolization and transjugular intrahepatic portosystemic shunt [TIPS]). This study aimed to investigate trends in incidence, treatment modalities, and outcome parameters, such as in\u2010hospital mortality and adverse events in Germany.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We evaluated the current epidemiological trends, therapeutic strategies, and in\u2010hospital mortality of AVH in Germany based on the standardized hospital discharge data provided by the German Federal Statistical Office from 2010 to 2019.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> A total of 65,357 AVH cases, predominately males (68.3%), were included in the analysis. The annual incidence rate (hospitalization cases per 100,000 persons) was 8.9. The in\u2010hospital mortality was 18.6%. The most common underlying disease was alcohol\u2010related liver cirrhosis (60.6%). The most common clinical complication was bleeding anemia (60.1%), whereas hypovolemic shock (12.8%) was the less frequent. In esophageal variceal hemorrhage (EVH), EVL was the most frequently performed endoscopic therapy, while in gastric variceal hemorrhage (GVH), EST and fibrin glue injection were the most commonly performed therapies. EVL showed the lowest in\u2010hospital mortality (12.3%) in EVH, while EST showed favorable results (14% in\u2010hospital mortality) in GVH. Combination therapies overall showed a higher in\u2010hospital mortality and were more frequent in GVH. The presence of hypovolemic shock, AKI, sepsis, artificial ventilation, ARDS, bleeding anemia, hepatic encephalopathy, and male sex was associated with a significantly worse outcome.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Our study provides detailed insight into the incidence, patient\u2010related risk factors, endoscopic treatment, and in\u2010hospital mortality in a sizeable AVH collective in Germany. These data might help improve risk stratification and treatment strategies for AVH patients in the future.<\/jats:p>","DOI":"10.1155\/2024\/5453294","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T10:49:59Z","timestamp":1729766999000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Acute Variceal Hemorrhage in Germany\u2013A Nationwide Study of 65,357 Hospitalized Cases"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7503-3862","authenticated-orcid":false,"given":"Alexander","family":"Mertens","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6652-5614","authenticated-orcid":false,"given":"Tobias","family":"Essing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1813-4228","authenticated-orcid":false,"given":"Anselm","family":"Kunstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Weigel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7141-0694","authenticated-orcid":false,"given":"Johannes","family":"Bode","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2245-6362","authenticated-orcid":false,"given":"Christoph","family":"Roderburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6288-8821","authenticated-orcid":false,"given":"Tom","family":"Luedde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennis","family":"Kandler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2799-2287","authenticated-orcid":false,"given":"Sven H.","family":"Loosen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra0901512"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01493-2"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.01.003"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cld.2013.12.001"},{"key":"e_1_2_13_5_2","first-page":"60","article-title":"Bleeding From Gastrointestinal Ectopic Varices Is Not Associated With Haemorrhage From Oesophageal or Gastric Varices","volume":"15","author":"Romano-Munive A. 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