Inpatient Management of Cirrhosis

Adapted from a powerpoint presentation by Yilin Zhang, MD; Neha Deshpande, MD and Eric Lamotte, MD.
Edits, updates and graphics by Yilin Zhang, MD.


  • Compensated vs. decompensated cirrhosis
  • Significance of MELD-Na score
  • Evaluation of acute decompensation
  • Management of common complications of cirrhosis

Part 1: Overview of Cirrhosis

Part 2: Complications of Cirrhosis 

Acute decompensation occurs when the there is an ↑ in MELD score or developement of one of the complications of cirrhosis. Click on each tab for additional details on each complication. 


  • MELD-Na score predicts 3 month mortality and is used for liver transplant allocation.
  • Acute decompensation of cirrhosis occurs when patients have an increase in their MELD-Na score or develop new complications of cirrhosis.
  • The precipitants of many of the complications of cirrhosis overlap and include infection/ SBP, GI bleeding or portal vein thrombosis and initial work-up should include diagnostic paracentesis, evaluation for clinical signs of bleeding and potentially a RUQ US with duplex.
  • Essentially everyone admitted to the hospital with cirrhosis and ascites should receive a diagnostic paracentesis.


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