Is it safe to consider anticoagulation in cirrhotic patients with venous thromboembolism?
Venous thromboembolism (VTE) increases the morbidity and mortality of the hospitalized patients. VTE can be seen in two different groups of people admitted to the hospitals. One group of patients is at very high risk of bleeding and the second group of patients is those without or with minimal risk of bleeding. When we plan thromboprophylaxis or treatment for VTE with the anticoagulants we are concerned about the risk of bleeding in special patients. Therefore, one should be aware of the number needed to harm (NNH) while considering the anticoagulation. In one population-based cohort of Coumadin patients 2% experienced a fatal bleeding event (NNH =50) and the overall major bleeding rate was 12% (NNH =8) (1).