Criteria for identifying failure of secondary prophylaxis to prevent upper gastrointestinal (GI) bleeding associated with portal hypertension were proposed at the Baveno IV Consensus Workshop. The workshop was held from April 28-29, 2005 in Italy.


Failure was defined as a single episode of clinically significant rebleeding from a portal hypertensive source.


Failure of secondary prophylaxis consists of both of the following:

(1) evidence of bleeding - one or more of the following:

(1a) fresh hematemesis

(1b) melena

(1c) aspiration of > 100 mL of fresh blood from a naso-gastric tube

(2) one of the following

(2a) drop in hemoglobin >= 3.0 grams if no transfusion given

(2b) adjusted blood requirement index (ABRI) >= 0.5 at any time if transfused



• The wording of the criteria on page 168 is a bit ambiguous. It was (1a OR 1b OR 1c) plus (2a) or (2b).


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