Original Article
Impact of liver cirrhosis on the outcomes of patients with venous thromboembolism: a case-control study
Abstract
Background: Venous thromboembolism (VTE) is increasingly encountered in cirrhotic patients. We conducted a retrospective case-control study to explore the difference in the clinical characteristics and outcomes between VTE patients with and without cirrhosis.
Methods: All VTE patients who were admitted between January 2011 and December 2015 were considered. Age, sex, and Charlson Comorbidity Index score (CCIs) were matched between VTE patients with and without cirrhosis.
Results: Sixteen and 160 patients were included in the case and control groups, respectively. The case group had higher Child-Pugh score, prothrombin time (PT), and international normalized ratio (INR) and lower red blood cell, platelet, and albumin than the control group. The frequency of anticoagulant therapies was significantly lower in the case group than in the control group [50% (8/16) vs. 90.6% (145/160), P<0.001]. The incidence of major bleeding and in-hospital mortality were significantly higher in the case group than in the control group [43.8% (7/16) vs. 13.8% (22/160), P=0.006; 37.5% (6/16) vs. 7.5% (12/160), P=0.002]. The most common origin of major bleeding in the case group is variceal [85.7% (6/7)]. In the case group, the incidence of major bleeding and in-hospital mortality were not significantly different between patients who received and did not receive anticoagulants [25% (2/8) vs. 62.5% (5/8), P=0.315; 25% (2/8) vs. 50% (4/8), P=0.608].
Conclusions: Cirrhosis may increase the risk of major bleeding and in-hospital death in patients with VTE. Anticoagulant therapies may not influence the risk of major bleeding and in-hospital death in cirrhosis with VTE.
Methods: All VTE patients who were admitted between January 2011 and December 2015 were considered. Age, sex, and Charlson Comorbidity Index score (CCIs) were matched between VTE patients with and without cirrhosis.
Results: Sixteen and 160 patients were included in the case and control groups, respectively. The case group had higher Child-Pugh score, prothrombin time (PT), and international normalized ratio (INR) and lower red blood cell, platelet, and albumin than the control group. The frequency of anticoagulant therapies was significantly lower in the case group than in the control group [50% (8/16) vs. 90.6% (145/160), P<0.001]. The incidence of major bleeding and in-hospital mortality were significantly higher in the case group than in the control group [43.8% (7/16) vs. 13.8% (22/160), P=0.006; 37.5% (6/16) vs. 7.5% (12/160), P=0.002]. The most common origin of major bleeding in the case group is variceal [85.7% (6/7)]. In the case group, the incidence of major bleeding and in-hospital mortality were not significantly different between patients who received and did not receive anticoagulants [25% (2/8) vs. 62.5% (5/8), P=0.315; 25% (2/8) vs. 50% (4/8), P=0.608].
Conclusions: Cirrhosis may increase the risk of major bleeding and in-hospital death in patients with VTE. Anticoagulant therapies may not influence the risk of major bleeding and in-hospital death in cirrhosis with VTE.
