Gastrointestinal (GI) bleeding is one of the most severe complication of cirrhosis and its predicting is crucial for the management of cirrhotic patients. The current study aimed to assess the relationship between international normalized ratio (INR) and serum fibrinogen level and the risk of GI bleeding in patients with cirrhosis

In the present cross-sectional study, 78 cirrhotic patients were enrolled. We assessed demographic, biochemical, and hematologic parameters in all patients. Underlying diseases and the etiology of cirrhosis were documented. The cirrhosis severity was assessed using Child- Pugh and the model for end-stage liver disease (MELD) scores. The history of bleeding episodes within 6 months before inclusion were recorded. A blood sample was drowned and fibrinogen and prothrombin time (PT) were measured and INR was calculated.

The patients’ mean age was 51.23±15.08 years and 40 (51.3%) were male. About 17 patients (21.7%) had a history of GI bleeding within 6 months before the study. The significant difference was detected between the two groups who experienced bleeding and who did not regarding the fibrinogen level (P < 0.05). The fibrinogen level of more than 182.5 could significantly predict the bleeding risk in cirrhotic patients (AUC: 0.87) with the sensitivity of 77%, and specificity of 94%.

According to the results, the fibrinogen level is a better predictor of bleeding in patients with liver cirrhosis compared with INR.