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• W3018915622 abstract "•Variceal bleeding is frequently associated with ACLF in cirrhosis.•ACLF is independently associated with rebleeding and mortality.•Patients with variceal bleeding and ACLF can benefit from a pre-emptive (early) TIPS. Background & AimsThe relationship between acute-on-chronic liver failure (ACLF) and acute variceal bleeding (AVB) is poorly understood. Specifically, the prevalence and prognosis of ACLF in the context of AVB is unclear, while the role of transjugular intrahepatic portosystemic shunt (TIPS) in the management in patients with ACLF has not been described to date.MethodsA multicenter, international, observational study was conducted in 2,138 patients from 34 centers between 2011 and 2015. ACLF was defined and graded according to the EASL-CLIF consortium definition. Placement of pre-emptive TIPS (pTIPS) was based on individual center policy. Patients were followed-up for 1 year, until death or liver transplantation. Cox regression and competing risk models (Gray's test) were used to identify independent predictors of rebleeding or mortality.ResultsAt admission, 380/2,138 (17.8%) patients had ACLF according to EASL-CLIF criteria (grade 1: 38.7%; grade 2: 39.2%; grade 3: 22.1%). The 42-day rebleeding (19% vs. 10%; p <0.001) and mortality (47% vs. 10%; p <0.001) rates were higher in patients with ACLF and increased with ACLF grades. Of note, the presence of ACLF was independently associated with rebleeding and mortality. pTIPS placement improved survival in patients with ACLF at 42 days and 1 year. This effect was also observed in propensity score matching analysis of 66 patients with ACLF, of whom 44 received pTIPs and 22 did not.ConclusionsThis large multicenter international real-life study identified ACLF at admission as an independent predictor of rebleeding and mortality in patients with AVB. Moreover, pTIPS was associated with improved survival in patients with ACLF and AVB.Lay summaryAcute variceal bleeding is a deadly complication of liver cirrhosis that results from severe portal hypertension. This study demonstrates that the presence of acute-on-chronic liver failure (ACLF) is the strongest predictor of mortality in patients with acute variceal bleeding. Importantly, patients with ACLF and acute variceal (re)bleeding benefit from pre-emptive (early) placement of a transjugular intrahepatic portosystemic shunt. The relationship between acute-on-chronic liver failure (ACLF) and acute variceal bleeding (AVB) is poorly understood. Specifically, the prevalence and prognosis of ACLF in the context of AVB is unclear, while the role of transjugular intrahepatic portosystemic shunt (TIPS) in the management in patients with ACLF has not been described to date. A multicenter, international, observational study was conducted in 2,138 patients from 34 centers between 2011 and 2015. ACLF was defined and graded according to the EASL-CLIF consortium definition. Placement of pre-emptive TIPS (pTIPS) was based on individual center policy. Patients were followed-up for 1 year, until death or liver transplantation. Cox regression and competing risk models (Gray's test) were used to identify independent predictors of rebleeding or mortality. At admission, 380/2,138 (17.8%) patients had ACLF according to EASL-CLIF criteria (grade 1: 38.7%; grade 2: 39.2%; grade 3: 22.1%). The 42-day rebleeding (19% vs. 10%; p <0.001) and mortality (47% vs. 10%; p <0.001) rates were higher in patients with ACLF and increased with ACLF grades. Of note, the presence of ACLF was independently associated with rebleeding and mortality. pTIPS placement improved survival in patients with ACLF at 42 days and 1 year. This effect was also observed in propensity score matching analysis of 66 patients with ACLF, of whom 44 received pTIPs and 22 did not. This large multicenter international real-life study identified ACLF at admission as an independent predictor of rebleeding and mortality in patients with AVB. Moreover, pTIPS was associated with improved survival in patients with ACLF and AVB." @default.
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• W3018915622 date "2020-11-01" @default.
• W3018915622 modified "2023-10-18" @default.
• W3018915622 title "Rebleeding and mortality risk are increased by ACLF but reduced by pre-emptive TIPS" @default.
• W3018915622 cites W1892110922 @default.
• W3018915622 cites W1951702026 @default.
• W3018915622 cites W2004585593 @default.
• W3018915622 cites W2007670274 @default.
• W3018915622 cites W2008945758 @default.
• W3018915622 cites W2024363563 @default.
• W3018915622 cites W2033876083 @default.
• W3018915622 cites W2086721895 @default.
• W3018915622 cites W2095764663 @default.
• W3018915622 cites W2129838212 @default.
• W3018915622 cites W2134599653 @default.
• W3018915622 cites W2145791480 @default.
• W3018915622 cites W2155510757 @default.
• W3018915622 cites W2159780330 @default.
• W3018915622 cites W2171716651 @default.
• W3018915622 cites W2296753619 @default.
• W3018915622 cites W2544418345 @default.
• W3018915622 cites W2576419792 @default.
• W3018915622 cites W2612977672 @default.
• W3018915622 cites W2743100185 @default.
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• W3018915622 doi "https://doi.org/10.1016/j.jhep.2020.04.024" @default.
• W3018915622 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/32339602" @default.
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