Abstract
Background
There is limited evidence on the efficacy of hemostatic powders in the management
of upper gastrointestinal bleeding.
Aims
Provide a pooled estimate of the efficacy and safety profile of hemostatic powders
in digestive endoscopy.
Methods
A computerized bibliographic search on the main databases was performed through December
2018. Pooled effects were calculated using a random-effects model. The primary outcome
was immediate hemostasis rate. Secondary outcomes were rebleeding rate (either at
7 and 30 days), bleeding-related mortality, and all-cause mortality rate.
Results
A total of 24 studies, of which three were randomized-controlled trials, with 1063
patients were included in the meta-analysis. Immediate hemostasis was achieved in
95.3% (93.3%–97.3%) of patients, with no difference based on treatment strategy, hemostatic
agent used, bleeding etiology. Success rate was slightly lower in spurting bleeding
(91.9%). Hemostatic powders showed similar efficacy as compared to conventional endoscopic
therapy (odds ratio: 0.84, 0.06–11.47; p = 0.9). Thirty-day rebleeding rate was 16.9%
(9.8%–24%) with no difference in comparison to other endoscopic treatments (odds ratio
1.59, 0.35–7.21; p = 0.55). All-cause and bleeding-related mortality rates were 7.6%
(4%–10.8%) and 1.4% (0.5%–2.4%), respectively.
Conclusion
Novel hemostatic powders represent a user-friendly and effective tool in the management
of upper gastrointestinal bleeding.
Keywords
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Article info
Publication history
Published online: August 07, 2019
Accepted:
July 8,
2019
Received:
March 25,
2019
Identification
Copyright
© 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
