title: Risks of venous thromboembolism in patients with liver cirrhosis: a nationwide cohort study in Taiwan.
abstract: BACKGROUND
  The results of various studies attempting to assess the risks of venous thromboembolism in liver cirrhosis have been conflicting. Furthermore, although the incidence of venous thromboembolism is thought to be low in Asians, the relationship between venous thromboembolism and liver cirrhosis has not been investigated in Asian countries.
  
  
  OBJECTIVE
  We investigated the risks of venous thromboembolism in cirrhotic patients in Taiwan to evaluate whether the risk is higher than in the general population.
  
  
  METHODS
  The data from 1,000,000 National Health Insurance beneficiaries were utilized. All adult beneficiaries were followed from 1 January 2007 to 31 December 2010 to identify those who developed venous thromboembolism. Each identified patient with liver cirrhosis was matched with 10 non-cirrhotic patients on the basis of high-dimensional propensity score. Cox regression models were applied to compare the hazards of venous thromboembolism in the matched cohorts.
  
  
  RESULTS
  A total of 757,940 patients were enrolled. After matching, 2223 cirrhotic patients and 22,230 non-cirrhotic patients were selected. The adjusted hazard ratio of venous thromboembolism was significantly increased by having cirrhosis (1.71; 95% confidence interval [CI] 1.05-2.78). A subgroup analysis revealed a much higher hazard ratio of venous thromboembolism in an advanced cirrhosis subgroup (n = 293) than in a matched non-cirrhosis subgroup (n = 2930) (4.36; 95% CI 1.36-14.01).
  
  
  CONCLUSIONS
  The risk of venous thromboembolism may be higher in Asian patients with cirrhosis than in the general Asian population, especially in those with advanced cirrhosis.
authors.affiliation: School of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
authors.forename: K-J
authors.initials: KJ
authors.lastname: Ng
authors.forename: Y-K
authors.initials: YK
authors.lastname: Lee
authors.forename: M-Y
authors.initials: MY
authors.lastname: Huang
authors.forename: C-Y
authors.initials: CY
authors.lastname: Hsu
authors.forename: Y-C
authors.initials: YC
authors.lastname: Su
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D057216:Propensity Score; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D054556:Venous Thromboembolism / Q000175:diagnosis / Q000208:ethnology*
keywords: cohort studies; liver cirrhosis; pulmonary embolism; venous thromboembolism; venous thrombosis