Luketic and Sanyal listed risk factors associated with recurrent bleeding in patients with esophageal varices. This can help identify patients who may require closer monitoring and more aggressive management. The authors are from the Medical College of Virginia in Richmond.


Risk Factors for Early Rebleed (within 6 weeks)

Risk Factors for Late Rebleed (> 6 weeks)



red signs on varices on endoscopy

red signs on varices on endoscopy

clot seen on varices


age > 60 years of age


previous bleed severe


renal failure

severe liver failure




active alcoholism

large varices




• Red signs on varices include red wale and cherry red spots.

• A bleed is considered severe if the hemoglobin is < 8 g/dL.

• Most early rebleeds occur within the first 10 days after the initial bleed.


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