Predictors of Non-Variceal Hemorrhage in a National Cohort of Patients with Chronic Liver Disease

Abstract Background: Non-variceal hemorrhage in patients with chronic liver disease (CLD) increases morbidity, mortality, and healthcare costs. There are limited data on risk factors for non-variceal hemorrhage in the CLD population. The aim of this study is to assess the predictive value of various clinical and laboratory parameters for non-variceal hemorrhage in CLD patients. Methods: We conducted a retrospective cohort study of U.S. veterans diagnosed with CLD between 2002 and 2018 within the Veterans Health Administration database. We derived candidate variables from existing risk prediction models for hemorrhage, risk calculators for severity of liver disease, Charlson index of prognostic comorbidities, and prior literature. We used a competing risk analysis to study the relationship between putative risk factors and incidence of non-variceal hemorrhage in patients with CLD. Results: Of 15,183 CLD patients with no history of cancer or anticoagulation use, 674 experienced non-variceal hemorrhage within one year of CLD diagnosis. In multivariable analysis, 11 of the 26 candidate variables independently predicted non-variceal hemorrhage: race, INR > 1.5, bilirubin >/= 2 mg/dL, albumin 更多