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)
ascites
ascites
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
hepatoma
active alcoholism
large varices
where:
• 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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