Liver cirrhosis is associated with venous thromboembolism among hospitalized patients in a nationwide US study.
OBJECTIVE
Studies on the impact of liver disease on venous thromboembolism (VTE) have produced conflicting results. We assessed the risk of VTE in patients with compensated or decompensated cirrhosis.


METHODS
Data on hospital discharges of patients with liver cirrhosis and a random sample of control patients (without liver disease, 1%) were analyzed from the Nationwide Inpatient Sample (1998-2006). Prevalence of VTE was compared among patients with and without cirrhosis. The impact of VTE on in-hospital mortality and length of stay (LOS) was assessed.


RESULTS
After multivariate adjustment, patients with compensated and decompensated cirrhosis were at higher risk of VTE until the age of 45 years (odds ratio [OR], 1.23; 95% confidence interval [CI], 1.04-1.46 and OR, 1.39; 95% CI, 1.15-1.69, respectively). After 45 years of age, compensated cirrhosis was associated with a modest decrease in adjusted odds of VTE (OR, 0.90; 95% CI, 0.85-0.95) whereas decompensated cirrhosis was not associated with higher risk of VTE (OR, 0.97; 95% CI, 0.91-1.04). VTE was associated with increased mortality among patients with compensated cirrhosis (OR, 2.16; 95% CI, 1.96-2.38) or decompensated cirrhosis (OR, 1.66, 95% CI, 1.47-1.87). VTE was associated with a 103% increase in length of stay (95% CI, 95%-111% increase) among patients with compensated cirrhosis and an 86% increase (95% CI, 78%-94% increase) among those with decompensated cirrhosis.


CONCLUSIONS
Patients with cirrhosis under the age of 45 years are at higher risk for VTE that those without liver disease and should be considered for VTE prophylaxis.
Wu
Harry
H
Mount Sinai Hospital Division of Gastroenterology, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
Nguyen
Geoffrey C
GC
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000401:mortality