title: Risk-assessment and pharmacological prophylaxis of venous thromboembolism in hospitalized patients with chronic liver disease.
abstract: BACKGROUND
  There is a lack of evidence regarding the need for thromboprophylaxis in hospitalized patients with liver disease. The purpose of this study was to evaluate the Padua Predictor Score (PPS) as a risk-stratification tool for the development of venous thromboembolism (VTE) in patients with chronic liver disease.
  
  
  METHODS
  This was a retrospective cohort study conducted in an academic medical center in the United States. Consecutive adult patients admitted with chronic liver disease were included. Patients were categorized into two groups based on whether they developed a VTE or not. The risk for VTE in each patient was evaluated using the Padua Predictor Score (PPS). Patients were risk stratified using the PPS score as high-risk (score ≥4) and low-risk (score <4). The risk of VTE based on PPS categorization was evaluated using logistic regression.
  
  
  RESULTS
  A total of 163 patients with liver disease were included in the study cohort. Of these, 18 (11%) developed VTE. Mean PPS was significantly greater in the VTE group than the non-VTE group (5.8 ± 2.0 versus 3.0 ± 2.1, respectively; p<0.001). In high-risk patients 22% (n=16/72) developed VTE and in low-risk patients 2% (2/91) developed VTE (p<0.001). High-risk patients were more likely to have VTE (OR 12.7, 95% CI 2.8 to 57.4, p=0.001).
  
  
  CONCLUSIONS
  The PPS is an effective risk assessment tool for VTE in patients hospitalized with chronic liver disease.
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, 1295N Martin Ave, PO Box 210202, Tucson, AZ, 85721, USA. Electronic address: bogari_h@hotmail.com.
authors.forename: Hanin
authors.initials: H
authors.lastname: Bogari
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, 1295N Martin Ave, PO Box 210202, Tucson, AZ, 85721, USA. Electronic address: patanwala@pharmacy.arizona.edu.
authors.forename: Asad E
authors.initials: AE
authors.lastname: Patanwala
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, 1295N Martin Ave, PO Box 210202, Tucson, AZ, 85721, USA. Electronic address: Richard.Cosgrove@uahealth.com.
authors.forename: Richard
authors.initials: R
authors.lastname: Cosgrove
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, The University of Arizona, 1295N Martin Ave, PO Box 210202, Tucson, AZ, 85721, USA. Electronic address: katz@pharmacy.arizona.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Katz
mesh_terms: D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D058625:End Stage Liver Disease / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000517:prevention & control*
chemical_list: D005343:Fibrinolytic Agents
keywords: Anticoagulants; Heparin; Liver cirrhosis; Liver diseases; Thromboembolism; Venous thromboembolism