Modest Performance of Risk-Prediction Models for Anticoagulant-Related Bleeding in Patients with Chronic Liver Disease

Patients with chronic liver disease (CLD) have a precarious hemostatic balance that can easily tip towards thrombosis or bleeding. These patients experience a higher risk of stroke [1], splanchnic vein thrombosis [2] and venous thromboembolism (i.e., deep venous thrombosis and pulmonary embolism) [3] than patients without liver disease. Liver disease also doubles the risk of anticoagulant-related bleeding [4]. As liver disease progresses, the risk of bleeding rises: one in three individuals with Child-Pugh B and C cirrhosis have bleeding with use of anticoagulant therapy [5].