Summary of findings 2. Cyanoacrylate 1 mL versus cyanoacrylate 0.5 mL for acute bleeding gastric varices in people with portal hypertension.
| Cyanoacrylate 1 mL versus cyanoacrylate 0.5 mL for acute bleeding gastric varices in people with portal hypertension | ||||||
| Patient or population: acute bleeding gastric varices in people with portal hypertension Settings: endoscopy room Intervention: cyanoacrylate 1 mL Control: cyanoacrylate 0.5 mL | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control: cyanoacrylate 0.5 mL | Intervention: cyanoacrylate 1 mL | |||||
| Total mortality Total deaths and the end of follow‐up Follow‐up: mean 26 months | Study population | RR 1.02 (0.65 to 1.60) | 91 (1 study) | ⊕⊝⊝⊝ very low1,2,3,4,5 | Only 1 trial. | |
| 447 per 1000 | 438 per 1000 (277 to 693) | |||||
| Moderate | ||||||
| 447 per 1000 | 438 per 1000 (277 to 693) | |||||
| 30 day ‐ mortality Mortality due to bleeding Follow‐up: mean 30 days | Study population | RR 1.07 (0.41 to 2.8) | 91 (1 study) | ⊕⊝⊝⊝ very low1,2,3,4,5 | Only 1 trial. | |
| 149 per 1000 | 159 per 1000 (61 to 417) | |||||
| Moderate | ||||||
| 149 per 1000 | 159 per 1000 (61 to 417) | |||||
| Failure of intervention Continuous bleeding after intervention Follow‐up: mean 1 day. | Study population | RR 1.07 (0.56 to 2.05) | 91 (1 study) | ⊕⊕⊝⊝ very low1,2,3,4,5 | Only 1 trial. | |
| 277 per 1000 | 296 per 1000 (155 to 567) | |||||
| Moderate | ||||||
| 277 per 1000 | 296 per 1000 (155 to 568) | |||||
| Complications (fever) Presence of fever Follow‐up: mean 26 months | Study population | RR 0.56 (0.32 to 0.98) | 91 (1 study) | ⊕⊝⊝⊝ very low1,2,3,4,5 | Only 1 trial. | |
| 489 per 1000 | 387 per 1000 (50 to 154) | |||||
| Moderate | ||||||
| 489 per 1000 | 386 per 1000 (50 to 154) | |||||
| Re‐bleeding Bleeding after initial success in the intervention Follow‐up: mean 1 weeks | Study population | RR 1.3 (0.73 to 2.31) | 91 (1 study) | ⊕⊝⊝⊝ very low1,2,3,4,5 | Only 1 trial. | |
| 298 per 1000 | 387 per 1000 (217 to 688) | |||||
| Moderate | ||||||
| 298 per 1000 | 387 per 1000 (218 to 688) | |||||
| Control of bleeding Success in control the active variceal bleeding Follow‐up: mean 26 months | Study population | RR 1.04 (0.78 to 1.38) | 25 (1 study) | ⊕⊝⊝⊝ very low1,2,3,4,5 | Only 1 trial. | |
| 867 per 1000 | 901 per 1000 (676 to 1000) | |||||
| Moderate | ||||||
| 867 per 1000 | 902 per 1000 (676 to 1000) | |||||
| *The basis for the assumed risk (e.g., the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio. | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 Assumed control risk: equates control group risk from the trial. 2 Downgraded one level due to serious risk of bias (only one trial rated as high risk of bias for unclear performance bias). 3 Downgraded two levels due to serious imprecision (only one trial with 91 participants in total, few events, 95% CI included appreciable benefit and harm). 4 Downgraded one level due to serious indirectness (only one type of population). 5 Downgraded one level due to likely publication bias (only one trial found).