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Bleeding and Thrombotic Risk in Cirrhosis: Hemostatic Profiles from a Single-Center Experience
Teodor Cabel1,2, Oana-Mihaela Plotogea1,2, Madalina Ilie1,2
1Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Life (Basel, Switzerland)
|June 26, 2026
Summary
Patients with cirrhosis face risks of both bleeding and clotting due to unstable hemostasis. Standard coagulation tests like INR and APTT are insufficient for predicting these events in advanced liver disease.
Area of Science:
- Hepatology
- Hematology
- Clinical Medicine
Background:
- Cirrhosis (CLD) disrupts hemostatic balance, increasing risks of both hemorrhage and thrombosis.
- Managing these dual risks in advanced liver disease (ALD) is clinically challenging.
- Identifying predictors for hemostatic complications is crucial for patient care.
Purpose of the Study:
- To evaluate coagulation profiles in cirrhotic patients.
- To assess the association between coagulation parameters and bleeding/thrombotic events.
- To identify potential predictors of hemostatic complications in cirrhosis.
Main Methods:
- Retrospective study of cirrhotic patients (Feb 2022-Mar 2024) at a liver transplant center.
- Inclusion criteria: availability of extended coagulation data.
- Analysis of demographic, clinical, and laboratory data for associations with thrombotic events and upper gastrointestinal bleeding (UGIB).
Main Results:
- 59 patients analyzed (mean age 53.4 years, 62.7% male).
- Incidence of UGIB: 18.6%; thrombotic events: 20.3%; portal vein thrombosis: 16.9%.
- Routine coagulation tests (INR, APTT) showed no significant predictive value for bleeding or thrombotic events.
Conclusions:
- Cirrhotic patients exhibit a complex, dual risk of bleeding and thrombosis.
- Standard coagulation tests are inadequate for accurate risk stratification in ALD.
- Further research is needed on advanced hemostatic assessment tools for cirrhotic patients.
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