A descriptive case series of patients with end-stage liver disease hospitalized with variceal bleeding who received pharmacologic venous thromboembolism prophylaxis.
BACKGROUND
It is unknown whether venous thromboembolism prophylaxis (VTEP) should be utilized in hospitalized patients with end-stage liver disease (ESLD), particularly in those admitted with variceal bleeding.


OBJECTIVE
We sought to describe a cohort of patients who received pharmacologic VTEP, specifically identifying the occurrence of rebleeding.


METHODS
Descriptive case series.


METHODS
All adult patients with ESLD admitted to an urban county teaching hospital over three years with variceal bleeding who received pharmacologic VTEP during hospitalization.


RESULTS
A total of 22 patients with ESLD and variceal bleeding received pharmacologic VTEP. Only 1 patient rebled after initiation of VTEP; 2 patients were diagnosed with lower extremity deep venous thrombosis while on VTEP including the 1 patient who rebled.


CONCLUSIONS
VTEP was associated with an unexpectedly low incidence of recurrent bleeding in patients with ESLD and variceal bleeding. Further study may be warranted.
Schleyer
Anneliese M
AM
Division of General Internal Medicine, Department of Medicine, Harborview Medical Center, Seattle, Washington 98104, USA. schleyer@u.washington.edu
Smith
Mark W
MW
Jarman
Kenneth M
KM
Crane
Paul K
PK
Schreuder
Astrid B
AB
Goss
J Richard
JR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D058625:End Stage Liver Disease / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D015912:Thrombolytic Therapy / Q000379:methods*; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*