This article is more than 5 years old. Information may no longer be current.
Liver disease linked to lower risk for venous thromboembolism
Click Here to Manage Email Alerts
Patients with moderate-to-severe liver disease demonstrated a lower risk for venous thromboembolism compared with those without liver disease, according to a population-based study.
However, those with moderate-severe liver disease who developed VTE had an increased risk for in-hospital mortality.
Traditionally, it had been believed patients with liver disease were protected against blood clots, but some studies have shown a potential increased risk for VTE.
“Chronic liver diseases are characterized by decreased levels of most procoagulant factors, reflected in an increased prothrombin time, and thrombocytopenia, leading to the assumption that they are a prototype of an acquired bleeding disorder,” Raquel Barba, PhD, medical area chief in the department of internal medicine at Hospital Universitario Rey Juan Carlos, Móstoles in Madrid, and colleagues wrote. “However, emerging evidence from recent studies show that the risk of VTE may be increased in patients with liver disease.”
Researchers used data from discharge reports from internal medicine departments at Spanish Public Health Service hospitals between 2005 and 2014 to assess the risk for VTE among those with liver disease. The analysis included data from 5,942,763 individuals, including 188,244 patients with mild liver disease and 135,823 with moderate-severe liver disease.
Researchers observed a VTE diagnosis among 2.7% of individuals (n = 157,654).
Patients with no liver disease had an overall VTE incidence rate of 2.7 per 100 patient discharges. Results showed patients with mild liver disease had an overall VTE incidence rate of 2.4 per 100 patient discharges and those with moderate-severe liver disease had an VTE incidence rate of 0.9 per 100 discharges.
The adjusted OR for having VTE was 1.13 (95% CI, 1.09-1.16) for mild liver disease, and 0.39 (95% CI, 0.37-0.49) for moderate-severe liver disease compared with no liver disease.
Among those who developed VTE, the in-hospital mortality rate was 21.7% among those with moderate-severe liver disease, 10.8% among those with no liver disease and 5.8% among those with mild liver disease.
The presence of VTE appeared associated with increased risk for mortality among those with no liver disease (OR = 1.16; 95% CI, 1.14-1.18) and those with moderate-severe liver disease (OR = 1.62; 95% CI, 1.42- 1.88).
The limitations of the study included lack of laboratory data, possible omitted or incorrect diagnoses, and inability to adjust for repeat admissions.
“Our population study using the Nationwide inpatient database suggests that VTE will occur in less than 2% of patients with liver diseases during their hospitalizations, and the risk of VTE is decreased by the presence of moderate-severe liver disease,” the researchers wrote. “But the development of VTE in these patients is associated with increased length of hospital stay and worse patient outcomes.” – by Cassie Homer
Disclosures: The authors report no relevant financial disclosures.
Click Here to Manage Email Alerts