Outcomes for splanchnic vein thrombosis poor in patients with liver cirrhosis
The risk of long-term and recurrent thrombotic events is elevated in cirrhotic patients with splanchnic vein thrombosis (SVT), a recent study has found.
A total of 604 consecutive SVT patients were enrolled in the study, of whom 149 (median age 59 years; 71.1 percent) were cirrhotic. Incidence rates of major bleeding, all-cause mortality and thrombotic events over a 2-year period were collected. Kaplan-Meier curves were constructed to evaluate overall survival rates, while Cox proportional hazards regression analyses were performed to identify potential predictors of the outcomes.
Nineteen cases of major bleeding were recorded during the follow-up period, resulting in an overall incidence rate of 9.8 per 100 patient-years. Major bleeding became progressively more common in patients with higher disease severity (Child-Pugh class A, B and C: 6.8, 15.4 and 33 cases per 100 patient-years, respectively).
In comparison, 25 thrombotic events were observed and yielded an incidence rate of 12.9 per 100 patient-years. Participants with more severe liver diseases were similarly more likely to suffer from recurrent vascular events.
The same was true for mortality, such as those with Child-Pugh class A diseases were less likely to die than those with class C liver disease. Overall, there were 42 deaths reported with an incidence rate of 17.5 per 100 patient-years.
Multivariable analysis revealed that ascites (hazard ratio [HR], 5.65; 95 percent CI, 1.92–16.64; p=0.002), a history of prior venous thromboembolism (HR, 14.73; 2.11–102.83; p=0.007) and a diagnosis of hepatocellular carcinoma (HR, 6.24; 2.45–15.85; p<0.001) were all associated with a significantly higher risk of mortality.