Background and aim: Portal vein thrombosis (PVT) is a rare complication in cirrhotic patients specially in advanced stages, multiple series demonstrated 5-20% prevalence in cirrhotic patients.
Aim: To identify risk factors for the development of PVT in cirrhotic patients.
Material and methods: Research Design: Case-control study. Procedure: We searched medical records from inpatients during 2019 with the diagnosis of PVT; cirrhotic patients with PVT were used as cases and paired in a 1:2 ratio with cirrhotic patients without PVT. Qualitative variables were depicted as frequencies and percentage, numeric variables as mean and standard deviation. X2, fisher's exact, student's t and Mann-Whitney's U were used to compare groups accordingly. Logistic regression was used to examine risk factors. P value <0.05 was considered statistically significant.
Results: Out of 1371 records, 40 patients with PVT were found (2.92%); 30 of them with cirrhosis were paired with 60 non-PVT cirrhotic patients. 53 (58.9%) were male; mean age: 56,2±13,9 years. According to Child-Pugh: 49 (54,4%) A, 22 (24,4%) B and 19 (21,1%) C. Fifteen (16,7%) had hepatocellular carcinoma (HCC). PVT was more prevalent in women than men (17/37 vs. 13/53 [45.9 vs. 24.5%]; OR=2.6, IC95%: 1.1-6.4; P=0.03). Patients with HCC had a higher prevalence of PVT against those without HCC (11/15 vs. 19/75 [73.3 vs. 25.3%]; OR=8.1, IC95%: 2.3-28.5; P=0.001). Decompensated cirrhosis patients had a higher rate of PVT than compensated patients (19/41 vs. 11/49 [46.3 vs. 22.4%]; OR=2.9, IC95%: 1.2-7.4; P=0.02). Adjusted multivariate logistic regression model is shown in Table 1.
Adjusted multivariate logistic regression model exploring risk factors for PVT in patients with cirrhosis.
| Variables | P | OR | 95%CI | |
|---|---|---|---|---|
| Lower | Upper | |||
| Female | 0.06 | 2.690 | 0.951 | 7.606 |
| Hepatocellular carcinoma | 0.005 | 7.722 | 1.876 | 31.783 |
| Child-Pugh B | 0.86 | 1.114 | 0.325 | 3.820 |
| Child-Pugh C | 0.07 | 3.184 | 0.889 | 11.400 |
| Constant | 0.000 | 0.165 | ||
Conclusions: PVT is more frequent in women and decompensated cirrhosis, the presence of HCC in cirrhotic patients is the main prothrombotic factor.
Conflicts of interest: The authors have no conflicts of interest to declare.
