{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T17:24:55Z","timestamp":1789925095745,"version":"4.0.1"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,12,7]],"date-time":"2017-12-07T00:00:00Z","timestamp":1512604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Early TIPS placement must be considered in patients with Child\u2010Pugh B and active bleeding at endoscopy or in patients with Child\u2010Pugh C 10\u201013 and variceal bleeding. However, active bleeding at endoscopy is a subjective criterion. Moreover, a previous study has shown that a MELD\u2010based score accurately predicted 6\u2010week mortality and helped to stratify patients. Using a prospective series of patients included in a multicentre study before the era of early TIPS, we aimed (i) to identify factors associated with 6\u2010week mortality, focusing on the prognostic value of active bleeding; and (ii) to assess whether a recalibrated MELD\u2010based score accurately predicted 6\u2010week mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ancillary study of the prospective multicentre Baveno IV study, including patients with acute variceal bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and nineteen patients were analysed (Child\u2010Pugh A\/B\/C\u00a0=\u00a018\/45\/37%). The overall actuarial likelihood of survival on day 42 was 84%. The variability for the diagnosis of active bleeding at endoscopy was high (range, 41.4% to 84.6% among the centres). Active bleeding at endoscopy was not associated with 6\u2010week mortality in the entire population or in Child\u2010Pugh B patients. In a multivariate analysis, independent factors associated with mortality were liver function, infection, HE and HCC. The recalibrated MELD\u2010based score was accurate in predicting 6\u2010week mortality (AUROC\u00a0=\u00a00.787). The recalibrated MELD\u2010based score demonstrated better performance compared to the MELD score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The recalibrated MELD\u2010based score accurately predicted mortality in our prospective cohort. Active bleeding at endoscopy had no prognostic value in cirrhotic patients presenting with acute variceal bleeding. Standardizing active bleeding assessment at endoscopy is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.13632","type":"journal-article","created":{"date-parts":[[2017,11,22]],"date-time":"2017-11-22T07:22:45Z","timestamp":1511335365000},"page":"469-476","source":"Crossref","is-referenced-by-count":41,"title":["Recalibrated MELD and hepatic encephalopathy are prognostic factors in cirrhotic patients with acute variceal bleeding"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9155-3345","authenticated-orcid":false,"given":"Marika","family":"Rudler","sequence":"first","affiliation":[{"name":"AP\u2010HP UPMC Department of Hepatogastroenterology La Piti\u00e9\u2010Salp\u00eatri\u00e8re Hospital Assistance Publique\u2010H\u00f4pitaux de Paris Pierre et Marie Curie University  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Bureau","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9pato\u2010Gastroent\u00e9rologie CHU de Toulouse  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Carbonell","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9patologie APHP UPMC H\u00f4pital Saint\u2010Antoine  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Mathurin","sequence":"additional","affiliation":[{"name":"Service des Maladies de l'Appareil digestif H\u00f4pital Huriez  Lille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faouzi","family":"Saliba","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9patologie H\u00f4pital Paul\u2010Brousse APHP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arianne","family":"Mallat","sequence":"additional","affiliation":[{"name":"Service d'H\u00e9patologie APHP H\u00f4pital Henri Mondor  Cr\u00e9teil 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