ArticleJournal of thrombosis and haemostasis : JTH2022
Different risks of hemorrhage in patients with elevated international normalized ratio from chronic liver disease versus warfarin therapy, a population-based retrospective cohort study.
Article in Journal of thrombosis and haemostasis : JTH, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed.
- Lactate-to-Hemoglobin Ratio as a Predictor of 30-Day Mortality in Patients with Non-Variceal Acute Upper Gastrointestinal Bleeding.Diagnostics (Basel, Switzerland) · 2026Article
- Evaluation of the Correlation of Serum Copeptin Levels Patients Diagnosed with Gastrointestinal System Bleeding with the Stage of Hemorrhagic Shock.The Eurasian journal of medicine · 2026Article
- Predicting short-term mortality in severe cirrhosis: An interpretable machine learning model integrating routine clinical indicators.PloS one · 2026Article
- Association between international normalized ratio-to-albumin ratio and mortality in critically ill patients with gastrointestinal bleeding: a retrospective MIMIC-IV database study.BMC gastroenterology · 2025Article
- Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case Report.Clinical practice and cases in emergency medicine · 2025Article
- Predictors of Non-Variceal Hemorrhage in a National Cohort of Patients With Chronic Liver Disease.Journal of hematology · 2024Article
- Article
- Relationship Between International Normalized Ratio to Albumin Ratio and Mortality in Critically Ill Patients With Myocardial Infarction.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
Corrections and comments
- Commented on by
Authors and funding
6 authors.
Funding
Abstract
backgroundPatients with chronic liver disease (CLD) often present with an elevated international normalized ratio (INR). Although elevated INR reflects a higher risk of hemorrhage among warfarin users, its clinical significance in CLD patients is less clear.
objectivesWe used Veterans Health Administration data to quantify the association between INR and (non-variceal) hemorrhage in patients with CLD compared to warfarin users.
methodsWe performed a multivariate competing risk analysis to study the association between INR and hemorrhage in the two cohorts. We used an interaction term between INR and cohort (CLD/warfarin users) to test if INR had different effects on hemorrhage in the two cohorts.
resultsData from 80 134 patients (14, 412 with CLD and 65, 722 taking warfarin) were analyzed. The effect of INR on the risk of hemorrhage differed between CLD patients and warfarin users (interaction P < .001). As INR increased above 1.5, the adjusted hazard ratio (aHR) for hemorrhage in CLD patients increased to 2.25 but remained fairly constant with further elevation of INR values. In contrast, the risk of hemorrhage in patients taking warfarin remained low with INR in the subtherapeutic (INR <2.0) and therapeutic ranges (INR 2.0-3.0), and increased exponentially with INR in the supratherapeutic range (aHR 1.64 with INR >3.0-3.5, and 4.70 with INR >3.5).
conclusionsThe relationship between INR and risk of hemorrhage in CLD patients is different from that in warfarin users. Caution should be exercised extrapolating data from warfarin users to make clinical decisions in CLD patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.