Abstract Number: PB2251
Meeting: ISTH 2020 Congress
Background: There are limited data with regards to the prevalence, risk factors and clinical outcomes in cirrhotic patients who have Portal vein thrombosis (PVT).
Aims: The aims of this study was to investigate the prevalence and risk factors of PVT in cirrhotic patients. In addition, we sought to investigate the association between the PVT and clinical outcomes in cirrhotic patients.
Methods: A single center nested case-control study was conducted between January 2006 and December 2018. Consecutive patients who were diagnosed with cirrhosis were screened. Cases were selected if patients had a subjective evidence of PVT. Controls were randomly selected in the same cohort using an 1:1 ratio, matching by age, sex and date of the diagnosis of cirrhosis.
Results: A total of 6,071 cirrhotic patients were included in this study. The prevalence of PVT in cirrhotic patients was 2.7% (95% confidence interval [CI] 2.2%-3.1%).. On the multivariable analysis, the independent risk factors of PVT in cirrhosis were Child-Pugh B or C (odds ratios [OR]=3.20, 95%CI: 1.77-5.76, P< 0.001), history of variceal bleeding (OR=2.61 95%CI: 1.33-5.11, P=0.01) and hepatocellular carcinoma (HCC) (OR=10.46, 95%CI: 5.97-18.33 P< 0.001). Among patients PVT who were left untreated, 59.6% had a progression of PVT. Patients with PVT and HCC had the significant higher risk of death when compared with cirrhotic patients who did not have PVT or HCC with a hazard ratio [HR] of 6.59, 95%CI 4.60-9.46, Figure A. A median follow-up period of patients in this cohort was 2.2 years. Figure B demonstrates the overall survival of cirrhotic patients according to HCC and PVT status.
Conclusions: The findings of this study suggest that patients with advance cirrhosis (Child-Pugh B/C or history of variceal bleeding) or those with HCC should be systematically investigated for PVT. Among patients with PVT who are not anticoagulated, majority of these patients have progression of PVT.
To cite this abstract in AMA style:Tavornshevin P, Leerapun A, Rattarittamrong E, Norrasethada L, Piriyakhuntorn P, Hantrakool S, Tantiworawit A, Rattanathammethee T, Chai-Adisaksopha C. Association of Portal Vein Thrombosis and Clinical Outcomes in Cirrhotic Patients: A Nested Case-Control Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/association-of-portal-vein-thrombosis-and-clinical-outcomes-in-cirrhotic-patients-a-nested-case-control-study/. Accessed November 26, 2020.
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