Abstract
BACKGROUND Chronic liver disease causes an imbalance in the coagulation system, but available data on liver disease and risk of venous thrombosis are conflicting. Clinical studies are therefore needed to understand the prevalence and risk factors associated with mortality to decide appropriate care of these patients. We studied the incidence of venous thrombosis in three CTP (Child-Turcotte-Pugh) class of cirrhotic patients and associated risk factors predicting 90-day mortality. METHODS A cross sectional observational study of one-year duration was conducted at a tertiary-care teaching hospital among patients admitted with chronic liver disease. 150 hospitalised patients with cirrhosis were enrolled and followed up for 3 months. Incidence of thrombosis was recorded in different CTP subclass. Threemonth mortality rates in different subgroups were compared by using normal test of proportions. The association between types of thrombosis and CTP class of liver cirrhosis was studied using Mann-Whitney U test, a non-parametric test. Mortality association with various parameters was evaluated using non-parametric test. Pvalue of ≤ 0.05 was considered significant. RESULTS Incidence of venous thrombosis in cirrhotic patients was 4 % in this study. Association of thrombosis with various clinical parameters and different CTP subclass was statistically non-significant. During the 3-months follow-up 24 patients died. Deceased had higher CTP score (mean CTP score - 9.58) as compared to survivors (mean CTP - 8.48) (P-value 0.049). Presence of ascites (Pvalue 0.037), higher serum urea (P-value 0.001), creatinine (P = 0.004), and total leucocyte count (P = 0.008) were significantly associated with mortality. CONCLUSIONS Thrombosis in chronic liver disease (CLD) especially portal vein is common and presents a therapeutic challenge as these patients are also at increased risk of bleeding. Higher CTP score, serum creatinine, leucocyte count and presence of ascites in CLD patients at admission are poor prognostic markers. KEYWORDS Deep Venous Thrombosis, Chronic Liver Disease, Cirrhosis, Thrombosis, Portal Vein Thrombosis
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