{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:42:17Z","timestamp":1792654937355,"version":"4.5.0"},"reference-count":41,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["cghjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Clinical Gastroenterology and Hepatology"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.cgh.2026.07.007","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:10:43Z","timestamp":1784733043000},"page":"2942-2955","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prior Decompensation Identifies Patients at High Mortality Risk Despite Standard Therapy After Variceal Hemorrhage: An Individual Patient Data Meta-Analysis"],"prefix":"10.1016","volume":"24","author":[{"given":"Laura","family":"Turco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"La Mura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pol","family":"Olivas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Rudler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candid","family":"Villanueva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Hernandez-Gea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohong","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakkarin","family":"Chirapongsathorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Shalimar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Bucsics","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e8 Maria","family":"Palazon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Thabut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Garcia-Guix","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuefeng","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanchit","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samagra","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaume","family":"Bosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Carlos","family":"Garcia-Pagan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0430-1786","authenticated-orcid":false,"given":"Gennaro","family":"D\u2019Amico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guadalupe","family":"Garcia-Tsao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.cgh.2026.07.007_bib1","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1002\/bjs.1800600817","article-title":"Transection of the oesophagus for bleeding oesophageal varices","volume":"60","author":"Pugh","year":"1973","journal-title":"Br J Surg"},{"key":"10.1016\/j.cgh.2026.07.007_bib2","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/j.jhep.2021.12.022","article-title":"Baveno VII \u2013 renewing consensus in portal hypertension","volume":"76","author":"de Franchis","year":"2022","journal-title":"J Hepatol"},{"key":"10.1016\/j.cgh.2026.07.007_bib3","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1053\/j.gastro.2020.09.026","article-title":"Effects of early placement of transjugular portosystemic shunts in patients with high-risk acute variceal bleeding: a meta-analysis of individual patient data","volume":"160","author":"Nicoar\u0103-Farc\u0103u","year":"2021","journal-title":"Gastroenterology"},{"key":"10.1016\/j.cgh.2026.07.007_bib4","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1097\/HEP.0000000000000647","article-title":"AASLD Practice Guidance on risk stratification and management of portal hypertension and varices in cirrhosis","volume":"79","author":"Kaplan","year":"2023","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2026.07.007_bib5","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1097\/HEP.0000000000000530","article-title":"AASLD Practice Guidance on the use of TIPS, variceal embolization, and retrograde transvenous obliteration in the management of variceal hemorrhage","volume":"79","author":"Lee","year":"2024","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2026.07.007_bib6","doi-asserted-by":"crossref","first-page":"W1","DOI":"10.7326\/M18-1377","article-title":"PROBAST: a tool to assess risk of bias and applicability of prediction model studies: explanation and elaboration","volume":"170","author":"Moons","year":"2019","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.cgh.2026.07.007_bib7","first-page":"1","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"10.1016\/j.cgh.2026.07.007_bib8","first-page":"4","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"10.1016\/j.cgh.2026.07.007_bib9","series-title":"Competing risks. A practical perspective","author":"Pintile","year":"2006"},{"key":"10.1016\/j.cgh.2026.07.007_bib10","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1177\/1536867X1701700110","article-title":"The estimation and modeling of cause-specific cumulative incidence functions using time-dependent weights","volume":"17","author":"Lambert","year":"2017","journal-title":"Stata J"},{"key":"10.1016\/j.cgh.2026.07.007_bib11","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","article-title":"Regression models and life tables","volume":"34","year":"1972","journal-title":"J R Stat Soc B"},{"key":"10.1016\/j.cgh.2026.07.007_bib12","series-title":"Proceedings of the fifth Berkeley Symposium on mathematical statistics and probability","first-page":"221","article-title":"The behavior of maximum likelihood estimates under nonstandard conditions","author":"Huber","year":"1967"},{"key":"10.1016\/j.cgh.2026.07.007_bib13","doi-asserted-by":"crossref","first-page":"817","DOI":"10.2307\/1912934","article-title":"A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity","volume":"48","author":"White","year":"1980","journal-title":"Econometrica"},{"key":"10.1016\/j.cgh.2026.07.007_bib14","first-page":"136","article-title":"A non-iterative algorithm for least squares estimation of missing values in any analysis of variance design","volume":"21","author":"Rubin","year":"1972","journal-title":"J R Stat Soc C"},{"key":"10.1016\/j.cgh.2026.07.007_bib15","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1177\/0962280206074463","article-title":"Multiple imputation of discrete and continuous data by fully conditional specification","volume":"16","author":"van Buuren","year":"2007","journal-title":"Stat Methods Med Res"},{"key":"10.1016\/j.cgh.2026.07.007_bib16","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1177\/1536867X0900900205","article-title":"Multiple imputation of missing values: new features for mim","volume":"9","author":"Royston","year":"2009","journal-title":"Stata J"},{"key":"10.1016\/j.cgh.2026.07.007_bib17","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1002\/sim.4067","article-title":"Multiple imputation using chained equations: issues and guidance for practice","volume":"30","author":"White","year":"2011","journal-title":"Stat Med"},{"key":"10.1016\/j.cgh.2026.07.007_bib18","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1002\/sim.7141","article-title":"Meta-analysis using individual participant data: one-stage and two-stage approaches, and why they may differ","volume":"36","author":"Burke","year":"2017","journal-title":"Stat Med"},{"key":"10.1016\/j.cgh.2026.07.007_bib19","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1177\/1536867X1501500203","article-title":"Two-stage individual participant data meta-analysis and generalized forest plots","volume":"15","author":"Fisher","year":"2015","journal-title":"Stata J"},{"key":"10.1016\/j.cgh.2026.07.007_bib20","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"key":"10.1016\/j.cgh.2026.07.007_bib21","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1002\/sim.1186","article-title":"Quantifying heterogeneity in a meta-analysis","volume":"21","author":"Higgins","year":"2002","journal-title":"Stat Med"},{"key":"10.1016\/j.cgh.2026.07.007_bib22","doi-asserted-by":"crossref","first-page":"4321","DOI":"10.1002\/sim.2692","article-title":"A simulation study comparing properties of heterogeneity measures in meta-analyses","volume":"25","author":"Mittlbuock","year":"2006","journal-title":"Stat Med"},{"key":"10.1016\/j.cgh.2026.07.007_bib23","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1136\/gut.2008.171207","article-title":"Nadolol plus isosorbide mononitrate alone or associated with band ligation in the prevention of recurrent bleeding: a multicentre randomised controlled trial","volume":"58","author":"Garc\u00eda-Pag\u00e1n","year":"2009","journal-title":"Gut"},{"key":"10.1016\/j.cgh.2026.07.007_bib24","first-page":"236","article-title":"Assessing the short- and long-term prognosis of patients with cirrhosis and acute variceal bleeding","volume":"101","author":"Sempere","year":"2009","journal-title":"Rev Esp Enferm Dig"},{"key":"10.1016\/j.cgh.2026.07.007_bib25","doi-asserted-by":"crossref","first-page":"833","DOI":"10.14309\/ajg.0000000000002018","article-title":"Assessing the risk of further decompensation and survival in patients with cirrhosis with variceal bleeding as their first decompensation event","volume":"118","author":"Gupta","year":"2023","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.cgh.2026.07.007_bib26","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.223201","article-title":"Small-diameter transjugular intrahepatic portosystemic shunt versus endoscopic variceal ligation plus propranolol for variceal rebleeding in advanced cirrhosis","volume":"308","author":"Wang","year":"2023","journal-title":"Radiology"},{"key":"10.1016\/j.cgh.2026.07.007_bib27","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1111\/liv.15937","article-title":"Influence of further decompensation on survival across clinical stages of decompensated cirrhosis: the role of portal hypertension and HVPG changes","volume":"44","author":"Guix","year":"2024","journal-title":"Liver Int"},{"key":"10.1016\/j.cgh.2026.07.007_bib28","doi-asserted-by":"crossref","first-page":"2370","DOI":"10.1056\/NEJMoa0910102","article-title":"Early use of TIPS in patients with cirrhosis and variceal bleeding","volume":"362","author":"Garc\u00eda-Pag\u00e1n","year":"2010","journal-title":"N Engl J Med"},{"key":"10.1016\/j.cgh.2026.07.007_bib29","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jhep.2012.08.020","article-title":"Use of early-TIPS for high-risk variceal bleeding: results of a post-RCT surveillance study","volume":"58","author":"Garcia-Pag\u00e1n","year":"2013","journal-title":"J Hepatol"},{"key":"10.1016\/j.cgh.2026.07.007_bib30","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1111\/apt.12934","article-title":"Early-TIPSS placement prevents rebleeding in high-risk patients with variceal bleeding, without improving survival","volume":"40","author":"Rudler","year":"2014","journal-title":"Aliment Pharmacol Ther"},{"key":"10.1016\/j.cgh.2026.07.007_bib31","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1002\/hep.29056","article-title":"A randomized trial to assess whether portal pressure guided therapy to prevent variceal rebleeding improves survival in cirrhosis","volume":"65","author":"Villanueva","year":"2017","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2026.07.007_bib32","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jhep.2017.09.002","article-title":"Cirrhotic patients with portal hypertension-related bleeding and an indication for early-TIPS: a large multicentre audit with real-life results","volume":"68","author":"Thabut","year":"2018","journal-title":"J Hepatol"},{"key":"10.1016\/j.cgh.2026.07.007_bib33","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1002\/hep.30182","article-title":"Preemptive-TIPS improves outcome in high-risk variceal bleeding: an observational study","volume":"69","author":"Hern\u00e1ndez-Gea","year":"2019","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2026.07.007_bib34","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S2468-1253(19)30090-1","article-title":"Articles early TIPS with covered stents versus standard treatment for acute variceal bleeding in patients with advanced cirrhosis: a randomised controlled trial","volume":"4","author":"Lv","year":"2019","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"10.1016\/j.cgh.2026.07.007_bib35","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/j.dld.2020.06.005","article-title":"Early rebleeding increases mortality of variecal bleeders on secondary prophylaxis with \u03b2 -blockers and ligation","volume":"52","author":"Ardevol","year":"2020","journal-title":"Dig Liver Dis"},{"key":"10.1016\/j.cgh.2026.07.007_bib36","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/j.dld.2019.01.011","article-title":"Albumin-Bilirubin (ALBI) as an accurate and simple prognostic score for chronic hepatitis B-related liver cirrhosis","volume":"51","author":"Wang","year":"2019","journal-title":"Dig Liver Dis"},{"key":"10.1016\/j.cgh.2026.07.007_bib37","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1002\/hep.28906","article-title":"Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the Study of Liver Diseases","volume":"65","author":"Garcia-Tsao","year":"2017","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2026.07.007_bib38","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jhep.2018.03.024","article-title":"EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis","volume":"69","author":"Angeli","year":"2018","journal-title":"J Hepatol"},{"key":"10.1016\/j.cgh.2026.07.007_bib39","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1097\/HEP.0000000000000652","article-title":"Further decompensation in cirrhosis: results of a large multicenter cohort study supporting Baveno VII statements","volume":"79","author":"D\u2019Amico","year":"2024","journal-title":"Hepatology"},{"key":"10.1016\/j.cgh.2026.07.007_bib40","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1016\/j.jhep.2023.04.028","article-title":"TIPS prevents further decompensation and improves survival in patients with cirrhosis and portal hypertension in an individual patient data meta-analysis","volume":"79","author":"Larrue","year":"2023","journal-title":"J Hepatol"},{"key":"10.1016\/j.cgh.2026.07.007_bib41","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.jhep.2023.10.007","article-title":"Predicting survival in patients with \u2018non-high-risk\u2019 acute variceal bleeding receiving \u03b2-blockers+ligation to prevent re-bleeding","volume":"80","author":"Balcar","year":"2024","journal-title":"J Hepatol"}],"container-title":["Clinical Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356526005483?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1542356526005483?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:30:56Z","timestamp":1792654256000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1542356526005483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":41,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["S1542356526005483"],"URL":"https:\/\/doi.org\/10.1016\/j.cgh.2026.07.007","relation":{},"ISSN":["1542-3565"],"issn-type":[{"value":"1542-3565","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Prior Decompensation Identifies Patients at High Mortality Risk Despite Standard Therapy After Variceal Hemorrhage: An Individual Patient Data Meta-Analysis","name":"articletitle","label":"Article Title"},{"value":"Clinical Gastroenterology and Hepatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.cgh.2026.07.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Published by Elsevier Inc. on behalf of American Gastroenterological Association Institute.","name":"copyright","label":"Copyright"}]}}