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. DESIGN: Descriptive case series. SETTING/PATIENTS: 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. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.