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Management of variceal haemorrhage in cirrhosis: the relevance of the risk stratification
  1. Lucio Amitrano,
  2. Maria Anna Guardascione,
  3. Antonella Menchise,
  4. Francesco Manguso,
  5. Antonio Balzano
  1. Gastroenterology Unit, A. Cardarelli Hospital, Naples, Italy
  1. Correspondence to Lucio Amitrano, Via Morghen 92, Naples 80129, Italy; luamitra{at}tin.it

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We read with interest the recent article by Mehta et al updating the diagnosis and the primary and secondary prophylaxis of variceal haemorrhage (VH) in cirrhosis.1 We would like to comment on the relevance of the degree of liver failure on the current strategies of management of VH.2 3 Prognosis after the bleeding episode has improved greatly in the last two decades, with the implementation of patient intensive care management, the use of vasoactive drugs, routine prophylactic antibiotics and band ligation, and with efficacious schedules of rebleeding prophylaxis.4 5 Nevertheless, in a recent classification VH, either in compensated or decompensated patients, defines the stage IV of cirrhosis bearing a mortality rate of 57% at 1 year.6 These results come …

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