SHM Converge Scientific Abstract ePoster Gallery-Vitamin K in Cirrhosis With Elevated Inr: A Systematic Review and Meta-Analysis

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This systematic review and meta-analysis examined whether vitamin K meaningfully corrects elevated INR in patients with cirrhosis and whether it improves bleeding outcomes. The authors searched PubMed and PubMed Central through September 2025 and included six adult studies (1,051 patients). Four studies provided data for INR change, and three reported bleeding outcomes.<br /><br />Overall, vitamin K produced only a small reduction in INR, with a pooled mean decrease of about 0.28 units. Fewer than one-third of patients achieved a clinically meaningful response, defined as a 30% INR reduction or INR ≤1.5. Vitamin K dosing in the studies ranged from 5–10 mg, usually given intravenously for 1–3 days.<br /><br />Importantly, vitamin K did not improve bleeding outcomes. Across available studies, there was no demonstrated reduction in procedural bleeding or other bleeding events. One study in patients with upper gastrointestinal bleeding found higher 30-day rebleeding rates among those given vitamin K. The overall certainty of evidence was low for INR outcomes and very low for bleeding outcomes because of inconsistency, bias, and imprecision.<br /><br />The authors conclude that routine vitamin K use solely to correct INR in cirrhosis should be discouraged. Elevated INR in cirrhosis usually reflects impaired liver synthetic function rather than true vitamin K deficiency or bleeding risk. Vitamin K may still be appropriate in selected patients with proven deficiency, such as those with severe malnutrition or chronic cholestasis, but not for routine INR correction in cirrhosis.

Asset Subtitle

Amit Kumar

Meta Tag

Author List Amit Kumar, Hamza Khan, Mansha Gupta, Ritu Yadav

Category Research

Concept Cirrhosis

Concept International Normalized Ratio

Concept Bleeding Risk

Concept Vitamin K

Concept Vitamin K Deficiency

Distinguished Non-Finalist

Presenter Organization Midwestern University

Presenting Author Amit Kumar

Track Outcomes Research

Keywords

vitamin K

cirrhosis

INR correction

systematic review

meta-analysis

bleeding outcomes

coagulopathy

liver disease

rebleeding

evidence certainty

Cirrhosis

International Normalized Ratio

Bleeding Risk

Vitamin K

Vitamin K Deficiency