Portal vein thrombosis in patients with cirrhosis: just a common finding or a predictor of poor outcome?
Journal Title: Annals of Hepatology - Year 2016, Vol 15, Issue 6
Abstract
Background & Aims. It is unclear whether portal vein thrombosis (PVT) unrelated to malignancy is associated with reduced survival or it is an epiphenomenon of advanced cirrhosis. The objective of this study was to assess clinical outcome in cirrhotic patients with PVT not associated with malignancy and determine its prevalence. Material and methods. Retrospective search in one center from June 2011 to December 2014. Results. 169 patients, 55 women and 114 men, median age 54 (19-90) years. Thirteen had PVT (7.6%). None of the patients received anticoagulant treatment. The PVT group was younger (49 [25-62] vs. 55 [19-90] years p = 0.025). Child A patients were more frequent in PVT and Child C in Non-PVT. Median Model for End Stage Liver Disease (MELD) score was lower in PVT (12 [8-21] vs. 19 [7-51] p ≤ 0.001) p ≤ 0.001). There was no difference between upper gastrointestinal bleeding and spontaneous bacterial peritonitis in the groups. Encephalopathy grade 3-4 (4 [30.8%] vs. 73 [46.8%] p = 0,007) and large volume ascites (5 [38.5%] vs. 89 [57.1%] p= 0,012) was more common in non-PVT. Survival was better for PVT (16.5 ± 27.9 vs. 4.13 ± 12.2 months p = 0.005). Conclusions: We found that PVT itself does not lead to a worse prognosis. The most reliable predictor for clinical outcome remains the MELD score. The presence of PVT could be just an epiphenomenon and not a marker of advanced cirrhosis.
Authors and Affiliations
Omar Borjas-Almaguer, Carlos Cortez-Hernández, Emmanuel González-Moreno, Francisco Bosques-Padilla, José González-González, Aldo Garza, Juan Martínez-Segura, Diego García-Compean, Juan Alejandre-Loya, Jesús García-García, Guillermo Delgado-García, Héctor Maldonado-Garza
Keywords
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