Impact of Anticoagulation on Upper Gastrointestinal Bleeding in Cirrhosis

Abstract

Background: Liver cirrhosis is often associated with upper gastrointestinal bleeding (UGIB), complicating the clinical management due to the fragile hemostatic balance and potential for portal hypertension-related complications. Anticoagulation therapy, while necessary for preventing thrombotic events, may increase the risk of bleeding, making its use in cirrhotic patients a critical area of study. Objective: To evaluate the impact of anticoagulation therapy on the incidence and severity of UGIB in patients with liver cirrhosis. Methods: This prospective study enrolled 100 patients with liver cirrhosis at the Asian Institute of Medical Sciences (AIMS) in Hyderabad. Patients were randomly assigned into two groups: Group A (n=50), receiving anticoagulation therapy, and Group B (n=50), without anticoagulation. UGIB sources were diagnosed via upper digestive endoscopy. Data were analyzed using SPSS version 26.0. Results: The mean age was 60.82 years (SD ± 8.98) in Group A and 62.20 years (SD ± 8.72) in Group B. Male participants comprised 68% and 62% of Groups A and B, respectively. Clinical outcomes showed shock incidence at 26% in Group A versus 12% in Group B (p=0.074), active bleeding at 30% versus 36% (p=0.523), hepatic failure at 20% versus 16% (p=0.603), and mortality rates at 16% versus 10% (p=0.372). Conclusion: The study indicates that anticoagulation therapy does not significantly impact the likelihood of adverse clinical outcomes in patients with liver cirrhosis. However, the need to balance thrombosis prevention with bleeding risk underscores the necessity for further large-scale studies to refine anticoagulation guidelines in this population.