How to prevent further decompensation in cirrhosis?
Further decompensation in cirrhosis represents a prognostic stage associated with an even higher mortality than that associated with first decompensation. Specific events that define further decompensation are any of the following:
a) Development of a second portal hypertension-driven decompensating event (ascites, variceal haemorrhage or hepatic encephalopathy) and/or jaundice;
b) Development of recurrent variceal bleeding, recurrent ascites (requirement of ≥3 large-volume paracenteses within 1 year), recurrent encephalopathy, development of spontaneous bacterial peritonitis and/or hepatorenal syndrome-acute kidney injury;
c) In patients presenting with bleeding alone, development of ascites, encephalopathy, or jaundice after recovery from bleeding but not if these events occur around the time of bleeding.
References:
Corrigendum to ‘Baveno VII – Renewing consensus in portal hypertension’ [J Hepatol (2022) 959-974] Journal of Hepatology, Vol. 77, Issue 2