Abstract
BackgroundCirrhotic patients are characterized by a decreased synthesis of coagulation and anticoagulation factors. The coagulopathy of cirrhotic patients is considered to be auto-anticoagulation. Our aim was to determine the incidence and predictors of venous thromboembolism (VTE) and examine the practice of deep venous thrombosis (DVT) prophylaxis among hospitalized cirrhotic patients.MethodsA retrospective cohort study was performed in a tertiary teaching hospital. We included all adult patients admitted to the hospital with a diagnosis of liver cirrhosis from January 1, 2009 to December 31, 2009. We grouped our cohort patients in two groups, cirrhotic patients without VTE and cirrhotic with VTE.ResultsOver one year, we included 226 cirrhotic patients, and the characteristics of both groups were similar regarding their clinical and laboratory parameters and their outcomes. Six patients (2.7%) developed VTE, and all of the VTEs were DVT. Hepatitis C was the most common (51%) underlying cause of liver cirrhosis, followed by hepatitis B (22%); 76% of the cirrhotic patients received neither pharmacological nor mechanical DVT prophylaxis.ConclusionCirrhotic patients are at risk for developing VTE. The utilization of DVT prophylaxis was suboptimal.
Highlights
Liver cirrhosis is a major health problem worldwide, especially in Saudi Arabia [1] where the prevalence of liver cirrhosis is not precisely known but is expected to be high due to the relatively high prevalence of viral hepatitis [2,3,4]
Study population A retrospective chart review was conducted of patients with discharge ICD-9 diagnosis codes corresponding to liver cirrhosis who were admitted to a tertiary care hospital in Riyadh, Saudi Arabia, from January 1, 2009 to December 31, 2009
General characteristics During the study period, 226 patients were admitted to the hospital with liver cirrhosis
Summary
Liver cirrhosis is a major health problem worldwide, especially in Saudi Arabia [1] where the prevalence of liver cirrhosis is not precisely known but is expected to be high due to the relatively high prevalence of viral hepatitis [2,3,4]. Liver cirrhosis is accompanied by multiple changes in the hemostatic system due to the reduced levels of natural inhibitors of coagulation and coagulation factors because of the impaired hepatic synthetic activity [5]. The pathogenesis of venous thromboembolism (VTE) in cirrhosis is complex and involves several factors, both endogenous changes associated with cirrhosis with increased levels of factors VII and protein C activity. The objective of the present study was to determine the incidence and predictors of VTE and to examine the practice of DVT prophylaxis among hospitalized cirrhotic patients. Our aim was to determine the incidence and predictors of venous thromboembolism (VTE) and examine the practice of deep venous thrombosis (DVT) prophylaxis among hospitalized cirrhotic patients
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