SynthesisAlimentary pharmacology & therapeutics2022
Systematic review with meta-analysis: incidence of variceal hemorrhage in patients with cirrhosis undergoing transesophageal echocardiography.
Synthesis in Alimentary pharmacology & therapeutics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus.Hepatology communications · 2026Article
- Coagulation Abnormalities in Liver Cirrhosis: Diagnostic and Therapeutic Approaches.Medicina (Kaunas, Lithuania) · 2026Review
- First Experience of Tricuspid Transcatheter-Edge-to-Edge Repair Using 3D Mini-Transesophageal Echocardiography and Intracardiac Echocardiography.JACC. Case reports · 2025Article
- Correlation between systemic inflammatory response syndrome and prognosis of patients with cirrhosis and hepatic encephalopathy.BMC gastroenterology · 2025Article
- Utility of transesophageal echocardiography during orthotopic liver transplantation: A narrative review.Annals of cardiac anaesthesiaReview
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundThe presence of esophageal varices is considered a relative contraindication to transesophageal echocardiography (TEE) by cardiology professional societies, so gastroenterologists are often consulted to perform upper endoscopy prior to TEE in patients with cirrhosis.
aimTo perform a systematic review to quantify the risk of bleeding complications in patients with cirrhosis following TEE.
methodsTwo reviewers searched Ovid MEDLINE, MEDLINE In-Process and EMBASE databases from January 1992 to May 2021 for studies reporting bleeding complications from TEE in patients with cirrhosis. We calculated the pooled incidence rate of bleeding events using the metaprop command with a random effect model.
resultsWe identified 21 studies comprising 4050 unique patients with cirrhosis; 9 studies (n = 3015) assessed the risk of intraoperative TEE during liver transplant (LT) and 12 studies (n = 1035) assessed bleeding risk in patients undergoing TEE for other indications. The pooled incidence of bleeding post-TEE was 0.37% (95% CI 0.04-0.94%) across all studies. Bleeding complications were low among patients undergoing TEE during LT as well as those undergoing TEE for other diagnostic reasons (0.97% vs. 0.004%) and among studies with mean MELD >18 compared to those with mean MELD <18 (0.43% vs. 0.08%). Few studies had a comparator arm, and data on patient-level factors impacting bleeding complications (including degree of liver dysfunction and coagulopathy) were limited across studies.
conclusionsThe risk of bleeding complications following TEE is low in patients with cirrhosis, suggesting TEE is safe and risk stratification with upper endoscopy may not be necessary.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.