Hepatology
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See the full rubric →An international multicenter analysis of the outcome of pediatric first variceal hemorrhage.
Clinical takeawayConsider referring pediatric patients with first variceal hemorrhage to high-volume centers, as outcomes are significantly better in these settings compared to low-volume centers. Monitor closely for decompensated disease, cirrhosis, or biliary atresia, as these factors are associated with diminished survival. Be cautious with sclerotherapy, as it is linked to worse outcomes.
What it foundOverall 6-week mortality after pediatric first variceal hemorrhage was 4.1%, with 1.4% in nonhospitalized subjects and significantly higher in low-volume centers (cluster 2) vs. high-volume centers (cluster 1) (P=.010).
ContextThis study confirms that pediatric variceal hemorrhage outcomes are diagnosis-specific and worse in decompensated disease, refining prior understanding of risk factors and center-specific influences.
No standard claimed for this paper
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Shneider BL … Grammatikopoulos T · Hepatology · IF 18.0 · PubMed ↗