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Impact of anticoagulation on upper-gastrointestinal bleeding in cirrhosis. A retrospective multicenter study

Federica Cerini1,2, Javier Martínez Gonzalez3,2, Ferran Torres4,5

  • 1Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic-IDIBAPS, University of Barcelona, Spain.

Hepatology (Baltimore, Md.)
|March 17, 2015
PubMed

Insights

Anticoagulation therapy (AT) does not impact outcomes for liver cirrhosis (LC) patients with upper gastrointestinal bleeding (UGIB). Multiorgan failure and comorbidity, not AT, predict outcomes in these patients.

Area of Science:

  • Hepatology
  • Gastroenterology
  • Clinical Medicine

Background:

  • Liver cirrhosis (LC) creates a hypercoagulable state, increasing thrombotic risk.
  • Anticoagulation therapy (AT) is increasingly used in LC patients.
  • The effect of AT on upper gastrointestinal bleeding (UGIB) outcomes in LC is unknown.

Purpose of the Study:

  • To investigate the impact of AT on UGIB outcomes in patients with LC.
  • To identify predictors of treatment failure and mortality in LC patients with UGIB on AT.

Main Methods:

  • Retrospective evaluation of 52 LC patients on AT with UGIB.
  • Comparison with 104 matched LC patients with UGIB not on AT.
  • Analysis of predictors for 5-day treatment failure and 6-week mortality.

Main Results:

  • AT did not predict 5-day treatment failure; SOFA score, UGIB source, and portal vein thrombosis (PVT) were predictors.
  • Predictors of 6-week mortality included SOFA score, Charlson Comorbidity Index, and AT use for cardiovascular disorders (CVDs).
  • No significant differences in rescue therapies, ICU admission, transfusions, or hospital stay between patients with or without AT.

Conclusions:

  • Treatment outcomes for UGIB in LC patients on AT are influenced by multiorgan failure and comorbidity.
  • Anticoagulation therapy itself was not found to be an independent predictor of adverse outcomes in this cohort.
Abstract

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