We thank Kumar and colleagues for their interest in our new algorithm for risk-stratification in candidates to secondary prophylaxis of variceal bleeding. In this algorithm, patients that bleed without other manifestations of hepatic decompensation are classified as low-risk without measuring the hepatic venous pressure gradient (HVPG). Using our new algorithm, a large number of invasive and costly HVPG measurements can be saved. More importantly, the number of high-risk patients who did not rebleed during follow-up (the "grey zone") decreased from 43% to 23%, demonstrating great accuracy in selecting high-risk patients.

Reply / V. La Mura, C. Villanueva, J.G. Abraldes, J. Bosch. - In: HEPATOLOGY. - ISSN 0270-9139. - 72:4(2020), pp. 1494-1495. [10.1002/hep.31253]

Reply

V. La Mura
Primo
Writing – Original Draft Preparation
;
2020

Abstract

We thank Kumar and colleagues for their interest in our new algorithm for risk-stratification in candidates to secondary prophylaxis of variceal bleeding. In this algorithm, patients that bleed without other manifestations of hepatic decompensation are classified as low-risk without measuring the hepatic venous pressure gradient (HVPG). Using our new algorithm, a large number of invasive and costly HVPG measurements can be saved. More importantly, the number of high-risk patients who did not rebleed during follow-up (the "grey zone") decreased from 43% to 23%, demonstrating great accuracy in selecting high-risk patients.
Gastrointestinal Hemorrhage; Humans; Liver Cirrhosis; Prognosis; Risk Assessment; Esophageal and Gastric Varices
Settore MED/09 - Medicina Interna
Settore MED/12 - Gastroenterologia
Settore MED/17 - Malattie Infettive
Settore MED/36 - Diagnostica per Immagini e Radioterapia
4-apr-2020
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/880789
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