Cirrhosis and Liver Failure
Prophylactic anticoagulation for venous thromboembolism in hospitalized cirrhosis patients is not associated with high rates of gastrointestinal bleeding
Article first published online: 12 JUN 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 34, Issue 1, pages 26–32, January 2014
How to Cite
Liver Int. 2014: 34:26–32
- Issue published online: 10 DEC 2013
- Article first published online: 12 JUN 2013
- Accepted manuscript online: 13 MAY 2013 09:03AM EST
- Manuscript Accepted: 29 APR 2013
- Manuscript Received: 18 JAN 2013
- deep venous;
- venous thromboembolism
Hospitalized patients with cirrhosis are at risk to develop venous thromboembolism. Although current guidelines support the routine administration of thromboprophylaxis to hospitalized patients, there is limited data regarding the safety or efficacy of this practice in hospitalized cirrhosis patients.
We aimed to determine if administration of thromboprophylaxis was associated with increased complication rates for hospitalized cirrhosis patients.
Data were collected on patients admitted to the University of Virginia between 2007 and 2010. Study personnel systematically collected data on complications, including gastrointestinal bleed, venous thromboembolism and death directly from the medical record.
A total of 235 patients (accounting for 355 discrete hospitalizations in which thromboprophylaxis was administered) met inclusion criteria accounting for 1660 person-days of thromboprophylaxis administered to patients. The mean age at admission was 58 (95% CI 57.1–59.2) years and 217 (61%) were male patients. The mean admission model for end-stage liver disease (MELD) score was 16.2 (95% CI 15.5–16.9). The mean hospital length of stay was 6.5 (95% CI 5.9–7.4) days. In patients who received thromboprophylaxis, the mean treatment length was 4.7 days (95% CI 4.2–5.2). There were nine gastrointestinal bleeding events (2.5% of admissions), five venous thromboembolisms (1.4% of admissions), two cases of heparin-induced thrombocytopenia (0.5% of admissions) and 14 deaths overall (3.9% of admissions).
The use of thromboprophylaxis in hospitalized cirrhosis patients is not associated with high rates of gastrointestinal bleeding or death.