Rosolowski et al listed risk factors associated with a first esophageal variceal bleeding. The authors are from multiple universities in Poland.
NOTE: The first three risk factors are also listed with the North Italian Endoscopic Club (NIEC) criteria (10.05.03).
Risk factors for a first esophageal variceal bleed:
(1) variceal size (large > medium > small)
(2) stigmata of imminent bleeding (red streaks and points on the variceal surface)
(3) Child-Pugh class C (indicative of advanced hepatic insufficiency)
(4) high portal pressure OR hepatic venous pressure gradient (HVPG) > 12 mm Hg
The presence of one or more risk factors is an indication for use of prophylaxis of variceal bleeding.
The risk of variceal bleeding may also be increased with cirrhosis secondary to viral hepatitis or alcohol abuse.
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Specialty: Gastroenterology
