Turon, Fanny; Driever, Ellen G; Baiges, Anna; Cerda, Eira; García-Criado, Ángeles; Gilabert, Rosa; Bru, Concepció; Berzigotti, Annalisa; Nuñez, Isabel; Orts, Lara; Reverter, Juan Carlos; Magaz, Marta; Camprecios, Genis; Olivas, Pol; Betancourt-Sanchez, Fabian; Perez-Campuzano, Valeria; Blasi, Annabel; Seijo, Susana; Reverter, Enric; Bosch, Jaime; ... (2021). Predicting portal thrombosis in cirrhosis: A prospective study of clinical, ultrasonographic and hemostatic factors. Journal of hepatology, 75(6), pp. 1367-1376. Elsevier 10.1016/j.jhep.2021.07.020
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BACKGROUND & AIMS
Portal vein thrombosis (PVT) is a relatively frequent event in patients with cirrhosis. While different risk factors for PVT have been reported, such as decreased portal blood flow velocity (PBFV) and parameters related with severity of portal hypertension, these are based on retrospective studies assessing only a discrete number of parameters. The aim of the current study was to evaluate the incidence and risks factors for non-tumoral PVT development in a large prospective cohort of patients with cirrhosis.
METHODS
We performed an exhaustive evaluation of clinical, biochemical, inflammatory and acquired/hereditary hemostatic profiles in 369 patients with cirrhosis without PVT who were prospectively followed-up. Doppler ultrasound was performed at baseline and every 6 months or whenever clinically indicated. PVT development was always confirmed by computed tomography.
RESULTS
Twenty-nine patients developed non-tumoral PVT, with an incidence of 1.6%, 6% and 8.4% at 1, 3 and 5 years, respectively. Low platelet count, PBFV <15 cm/sec and history of variceal bleeding were factors independently associated with a high PVT risk. No relationship between PVT development and any other clinical biochemical, inflammatory and acquired or hereditary hemostatic parameter was found.
CONCLUSIONS
In patients with cirrhosis, the factors predictive of PVT development were mainly those related to the severity of portal hypertension. Our results do not support the role of hemostatic alterations (inherited or acquired) and inflammatory markers in the prediction of PVT in patients with cirrhosis.
LAY SUMMARY
Patients with cirrhosis and more severe portal hypertension are at higher risk of non-tumoral portal vein thrombosis development. Acquired or inherited hemostatic disorders, as well as inflammatory status, do not seem to predict the development of portal vein thrombosis in patients with cirrhosis.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Hepatology |
UniBE Contributor: |
Berzigotti, Annalisa, Bosch Genover, Jaime |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1600-0641 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Rahel Fuhrer |
Date Deposited: |
27 Oct 2021 07:51 |
Last Modified: |
02 Mar 2023 23:35 |
Publisher DOI: |
10.1016/j.jhep.2021.07.020 |
PubMed ID: |
34333101 |
Uncontrolled Keywords: |
Cirrhosis portal hypertension portal vein thrombosis |
BORIS DOI: |
10.48350/160193 |
URI: |
https://boris.unibe.ch/id/eprint/160193 |
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