Variceal Bleeding International Study
Research type
Research Study
Full title
Defining high risk variceal bleeding: a rational for the use of early tips in acute bleeding and preventing rebleeding.
IRAS ID
145360
Contact name
Paul Richardson
Contact email
Sponsor organisation
Royal Liverpool & Broadgreen University Hospitals Trust
Research summary
Recent UK reports have highlighted the growing mortality and morbidity rates from cirrhosis. Varices generally develop in the oesophageal-gastric region as a consequence of the pressure rise in the portal venous system seen in cirrhosis. Acute variceal bleeding (AVB) is a serious complication of cirrhosis. Despite endoscopic variceal banding the current gold standard therapy, mortality remains high ~ 10%.
Several factors have been utilised to predict treatment failure and outcome however most lack external validation. There is a need therfore to identify robust clinical prognostic tools to guide clinical management.
A recent report has suggested improved survival by early insirtion of a Transjugular Intrahepatic Shunt(TIPS) for high risk AVB patients, these findings have been confirmed by small observational studies. However the number of patients in these studies were small and the place of early TIPS for AVB remains unclear.
There is also a group of AVB patients deemed low risk by current modeling that fail current standard of care therapy.
The present study aims to obtain prognostic information of >1500 patients with AVB admitted throughout Europe with the ultimate purpose of identifying the best prognostic factors defining high risk. It will also help to identify if there is a subgroup of patients initially classified as non-high risk who may benefit from an early-TIPS placement in order to prevent rebleeding.REC name
North West - Haydock Research Ethics Committee
REC reference
14/NW/1102
Date of REC Opinion
22 Sep 2014
REC opinion
Further Information Favourable Opinion