Obesity is not associated with an increased risk of portal vein thrombosis in cirrhotic patients.

Abstract

To determine the impact of obesity on development of portal vein thrombosis in cirrhotic patients. Cirrhosis is a known risk factor for portal vein thrombosis (PVT). Evidence also points to obesity as being a risk factor for venous thromboembolism. Limited information is available on how obesity impacts the development of PVT in cirrhotic patients. This was a retrospective cohort study using the 2013 National Inpatient Sample. Patients older than 18 years with an ICD-9 CM code for any diagnosis of liver cirrhosis were included. There was no exclusion criteria. The primary outcome was the impact of obesity on development of PVT. Obesity was also sub-classified according to body-mass index (BMI). Secondary outcomes were in-hospital mortality, ICU admission, shock, TPN use, and resource utilization. Odds ratios (OR) and means were adjusted for age, gender, and ethnicity. We included 69,934 obese cirrhotics of which, 1,125 developed PVT (mean age 59 years, 35% female). Overall in-hospital mortality rates were 9% (11% with PVT vs 5% without PVT). On multivariate analysis, obesity was not associated with a significantly different adjusted OR for development of PVT compared to non-obese. When stratifying by obesity subtype, class 1 obesity was associated with increased odds of PVT (OR: 1.45, 95%CI: 1.06-1.96, p=0.02), while class 3 obesity was associated with a decreased odds of PVT (OR: 0.72, 95%CI: 0.58-0.88, p<0.01) compared to non-obese. Obesity is not associated with increased odds of PVT.