Photo Credit: Mohammed Haneefa Nizamudeen

The following is a summary of “Predictors of Non-Variceal Hemorrhage in a National Cohort of Patients With Chronic Liver Disease,” published in the June 2024 issue of Hematology by Afzal et al.

Non-variceal hemorrhage in patients with chronic liver disease (CLD) significantly elevates morbidity, mortality, and healthcare expenses. However, data on the population’s risk factors contributing to non-variceal hemorrhage are limited.

Researchers conducted a retrospective study evaluating the predictive value of various clinical and laboratory parameters for non-variceal bleeding in patients with CLD. 

Using the Veterans Health Administration database, they analyzed U.S. veterans with CLD (2002 to 2018). Existing risk prediction models, liver disease severity calculators, the Charlson comorbidity index, and past studies were used to analyze factors linked to non-variceal hemorrhage using competing risk analysis. 

The results showed 15,183 patients with CLD without cancer history or anticoagulation use and 674 cases were found of non-variceal hemorrhage within a year of diagnosis. Multivariable analysis identified 11 out of 26 variables: race, international normalized ratio (INR)>1.5, high bilirubin (≥ 2 mg/dL), low albumin (≤ 3.5 g/dL), anemia, alcohol abuse, antiplatelet use, kidney disease, dementia, PPI use, and recent infection. 

Investigators concluded that, among nearly 15,000 veterans, non-Caucasian race, severe liver disease lab results, recent infection, and other bleeding risk factors found in patients without CLD increased the likelihood of non-variceal bleeding within the first year of CLD diagnosis.

Source: thejh.org/index.php/jh/article/view/1214/820