Skip to main content

Advertisement

SpringerLink
Log in

Predictors of early rebleeding and mortality after acute variceal hemorrhage in patients with cirrhosis

  • Practice Point
  • Published:

From Nature Clinical Practice Gastroenterology & Hepatology

View current issue Sign up to alerts

Abstract

Despite improvements over the past 20 years in patient survival following episodes of acute variceal hemorrhage (AVH) secondary to cirrhosis, AVH is still associated with a high rate of mortality. The ability to predict which patients are at high risk of death, or which are not likely to respond to standard therapy at admission to hospital is important, as it enables the immediate initiation of vasoactive drugs, early endoscopic intervention and prophylactic antibiotics. This commentary discusses a study that attempts to predict early rebleeding and mortality after AVH in patients with cirrhosis using the Model for End-stage Liver Disease. In this study, the model was a significant predictor of mortality; however, several defects in the study's design limit the conclusions that can be drawn from it. The model described in this study is neither more useful, nor more accurate, than those previously published for the prediction of rebleeding and mortality in patients with AVH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Cholongitas E et al. (2006) A systematic review of the performance of the Model for End-stage Liver Disease (MELD) in the setting of liver transplantation. Liver Transpl 12: 1049–1061

    Article  Google Scholar 

  2. Cholongitas E et al. (2005) Systematic review: Model for End-stage Liver Disease—should it replace Child–Pugh's classification for assessing prognosis in cirrhosis? Aliment Pharmacol Ther 22: 1079–1089

    Article  CAS  Google Scholar 

  3. Bambha K et al. (2008) Predictors of early re-bleeding and mortality after acute variceal haemorrhage in patients with cirrhosis. Gut 57: 814–820

    Article  CAS  Google Scholar 

  4. Burroughs AK et al. (2008) Predicting failure to control bleeding and mortality in acute variceal bleeding. J Hepatol 48: 185–188

    Article  CAS  Google Scholar 

  5. Ben Ari Z et al. (1999) A predictive model for failure to control bleeding during acute variceal haemorrhage. J Hepatol 31: 443–450

    Article  CAS  Google Scholar 

  6. Abraldes JG et al. (2008) Hepatic venous pressure gradient and prognosis in patients with acute variceal bleeding treated with pharmacologic and endoscopic therapy. J Hepatol 48: 229–236

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. AK Burroughs is a Consultant Physician, Hepatologist and Professor of Hepatology at The Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital, and University College School of Medicine, London, UK.,

    Andrew K Burroughs

  2. CK Triantos is a Research Fellow and J O'Beirne and D Patch are Consultant Physicians and Hepatologists, all at The Royal Free Sheila Sherlock Liver Centre, Royal Free Hospital, London, UK.,

    Christos K Triantos, James O'Beirne & David Patch

Authors
  1. Andrew K Burroughs
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christos K Triantos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James O'Beirne
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David Patch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew K Burroughs.

Ethics declarations

Competing interests

AK Burroughs is on the speakers' bureau (honoraria) for Ferring Pharmaceuticals. CK Triantos, J O'Beirne and D Patch declared no competing interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Burroughs, A., Triantos, C., O'Beirne, J. et al. Predictors of early rebleeding and mortality after acute variceal hemorrhage in patients with cirrhosis. Nat Rev Gastroenterol Hepatol 6, 72–73 (2009). https://doi.org/10.1038/ncpgasthep1336

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpgasthep1336

  • Springer Nature Limited

This article is cited by

Search

Navigation