Variation in Care for Children With Esophageal Varices: A Study of Physicians', Patients', and Families' Approaches and Attitudes

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dc.contributor.authorCristobal Gana, Juan
dc.contributor.authorValentino, Pamela L.
dc.contributor.authorMorinville, Veronique
dc.contributor.authorO'Connor, Constance
dc.contributor.authorLing, Simon C.
dc.date.accessioned2024-01-10T12:10:47Z
dc.date.available2024-01-10T12:10:47Z
dc.date.issued2011
dc.description.abstractBackground and Aims: Inadequate evidence to guide the management of children with esophageal varices may lead to variation in care and the provision of poor-quality care to some children. The aims of the study were to describe approaches taken by pediatric gastroenterologists for the management of esophageal varices in children, and to determine the attitudes of children, parents, and physicians toward screening endoscopy for identification of varices.
dc.description.abstractMethods: Canadian pediatric gastroenterologists and hepatologists were questioned about their approaches to screening for esophageal varices and therapy to prevent or treat variceal hemorrhage. Consecutive children with portal hypertension and their parents were surveyed about attitudes to screening endoscopy.
dc.description.abstractResults: Forty-seven of 72 (65%) physicians responded. Seventy percent of respondents screen for esophageal varices in selected children, most using endoscopy (77%). Fifty-eight percent of respondents who screen for varices would provide primary prophylactic treatment. Most would treat an acute variceal bleed with antibiotics, acid suppression, octreotide, and endoscopy within 24 hours (76%) and then secondary prophylaxis with endoscopic variceal ligation (96%) or beta-blockers (28%). Among 29 families surveyed, 63% of parents and 50% of patients would agree to screening endoscopy to understand their risk of variceal bleeding and 67% if prophylactic therapy were available. Families were more concerned about the risk of endoscopic adverse events than were gastroenterologists.
dc.description.abstractConclusions: Pediatric gastroenterologists vary in the care they provide for children at risk for esophageal varices and their attitudes toward the role of screening endoscopy differ from that of their patients. Further evidence is required to support practice guidelines that may reduce variation in care and thus improve its quality.
dc.fechaingreso.objetodigital2024-05-22
dc.format.extent5 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1097/MPG.0b013e318213be81
dc.identifier.eissn1536-4801
dc.identifier.issn0277-2116
dc.identifier.pubmedidMEDLINE:21593647
dc.identifier.urihttps://doi.org/10.1097/MPG.0b013e318213be81
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/76606
dc.identifier.wosidWOS:000290750500018
dc.information.autorucMedicina;Gana JC ;S/I;8726
dc.issue.numero6
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final755
dc.pagina.inicio751
dc.publisherLIPPINCOTT WILLIAMS & WILKINS
dc.revistaJOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION
dc.rightsacceso restringido
dc.subjectdiagnosis
dc.subjectdisease prevention management
dc.subjectendoscopy
dc.subjectesophageal and gastric varices
dc.subjecthypertension
dc.subjectpatient preference
dc.subjectportal
dc.subjectBILIARY ATRESIA
dc.subjectPORTAL-HYPERTENSION
dc.subjectRANDOMIZED-TRIAL
dc.subjectHEMORRHAGE
dc.subjectPORTOENTEROSTOMY
dc.subjectOBSTRUCTION
dc.subjectPREVENTION
dc.subjectPROGNOSIS
dc.subjectSURVIVAL
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleVariation in Care for Children With Esophageal Varices: A Study of Physicians', Patients', and Families' Approaches and Attitudes
dc.typeartículo
dc.volumen52
sipa.codpersvinculados8726
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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