Preventing Further Decompensation: Consensus Statements of Panel 7

Further decompensation in cirrhosis represents a prognostic stage associated with even higher mortality than that associated with the first decompensation. Specific events that define further decompensation are development of a second portal hypertension-driven event (ascites, variceal hemorrhage or hepatic encephalopathy) and/or jaundice, development of a complication of a decompensating event (recurrent ascites, recurrent encephalopathy, spontaneous bacterial peritonitis and/or hepatorenal syndrome. Strategies to prevent further decompensation in patients presenting with ascites and variceal hemorrhage are outlined as well as the role of infections and sarcopenia in the development of further decompensation. Finally, the concept of cirrhosis “re-compensation” is defined and a research agenda is put forward.