Procedural-Related Bleeding in Hospitalized Patients With Liver Disease (PROC-BLeeD): An International, Prospective,...

Area of Science:

• Hepatology
• Gastroenterology
• Internal Medicine

Background:

• Hospitalized patients with cirrhosis often require multiple procedures.
• The risk and management of procedural bleeding in this population are not well-defined.

Purpose of the Study:

• To determine the incidence of procedural-related bleeding in hospitalized cirrhosis patients.
• To identify independent risk factors for bleeding events.

Main Methods:

• An international, prospective, multicenter study involving 1187 patients undergoing 3006 nonsurgical procedures.
• Patients were monitored for 28 days post-admission or until a major event.

Main Results:

• Bleeding occurred in 6.9% of patient admissions and 3.0% of procedures; major bleeding in 2.3% and 0.9%, respectively.
• High-risk procedures, elevated Model for End-Stage Liver Disease (MELD) score, and higher Body Mass Index (BMI) independently predicted bleeding.
• Conventional hemostasis tests, prophylaxis, and antithrombotics were not predictive.

Conclusions:

• Procedural bleeding is infrequent in hospitalized cirrhosis patients.
• Patients with higher BMI and decompensated liver disease undergoing high-risk procedures face increased bleeding risk.
• Bleeding risk is not reliably predicted by standard tests or prophylaxis.