title: Thrombosis and hemorrhage in the critically ill cirrhotic patients: five years retrospective prevalence study.
abstract: BACKGROUND
  Cirrhotic patients present a complex interaction between deficient synthetic liver function, hemodynamic abnormalities and superimposed conditions that alter coagulation system. This alters both coagulation and fibrinolytic processes,increasing bleeding and thrombosis risks. Particularly, critically ill cirrhotic patients represent a diagnostic challenge since they have multiple comorbidities making the thrombotic and bleeding risks unpredictable. The prevalence of bleeding and thrombosis in this subset of patients remains poorly described. The main aim of this article is to describe the prevalence of thrombotic and hemorrhagic complications in cirrhotic patients admitted between 2007 and 2012 at Médica Sur Clinic and Foundation ICU.
  
  
  METHODS
  We performed a five years retrospective study including every cirrhotic patient admitted to ICU between January 2007 and December 2012.
  
  
  RESULTS
  The incidence of hemorrhage was 48.5%, the overall incidence of thrombotic complications was 13.66%. Variceal bleeding was the most prevalent hemorrhagic event and portal vein thrombosis the most common thrombotic event. Factors associated with presenting a bleeding episode included kidney injury, infection an thrombosis. Factors associated with increased thrombotic risk included ascitis,infection and bleeding.
  
  
  CONCLUSIONS
  Critically ill cirrhotic patients have an high risk for both thrombotic and bleeding episodes. The association between the presence of bleeding and thrombotic events was statistically significant.
authors.affiliation: Intensive Care Unit, Liver Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
authors.forename: Jimena
authors.initials: J
authors.lastname: Muciño-Bermejo
authors.affiliation: Intensive Care Unit, Liver Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
authors.forename: Raúl
authors.initials: R
authors.lastname: Carrillo-Esper
authors.affiliation: Intensive Care Unit, Liver Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
authors.forename: Nahum
authors.initials: N
authors.lastname: Méndez-Sánchez
authors.affiliation: Liver Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico.
authors.forename: Misael
authors.initials: M
authors.lastname: Uribe
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology; D000368:Aged; D001201:Ascites / Q000453:epidemiology; D016638:Critical Illness; D004932:Esophageal and Gastric Varices / Q000453:epidemiology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology*; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D007362:Intensive Care Units; D008103:Liver Cirrhosis / Q000453:epidemiology*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011169:Portal Vein; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology; D013927:Thrombosis / Q000453:epidemiology; D020246:Venous Thrombosis / Q000453:epidemiology*