Risks of Venous Thromboembolism in Patients with Liver Cirrhosis: A Nationwide Cohort Study in Taiwan.
J Thromb Haemost. 2014 Dec 4;
Authors: Ng KJ, Lee YK, Huang MY, Hsu CY, Su YC
BACKGROUND: The results of various studies attempting to assess the risks of venous thromboembolism in liver cirrhosis have been conflicting. Furthermore, while the incidence of venous thromboembolism is thought to be low in Asians, the relation between venous thromboembolism and liver cirrhosis has not been investigated in Asian countries.
OBJECTIVE: We investigated the risks of venous thromboembolism in cirrhotic patients in Taiwan to evaluate whether the risk is higher compared to the general population.
METHODS: The data from one million National Health Insurance (NHI) beneficiaries were utilized. All adult beneficiaries were followed from January 1, 2007 until December 31, 2010 to identify those who developed venous thromboembolism. Each identified patient with liver cirrhosis was matched with ten non-cirrhotic patients based on high-dimensional propensity score. Cox regression models were applied to compare the hazards of venous thromboembolism in the matched cohorts.
RESULTS: A total of 757,940 patients were enrolled. After matching, 2,223 cirrhotic patients and 22,230 non-cirrhotic patients were selected. The adjusted hazard ratio of venous thromboembolism was significantly increased by having cirrhosis (1.71; 95% CI, 1.05-2.78). A subgroup analysis revealed a much higher hazard ratio of venous thromboembolism in an advanced cirrhosis subgroup (n=293) than in a matched non-cirrhosis subgroup (n=2,930) (4.36; 95% CI, 1.36-14.01).
CONCLUSION: The risk of venous thromboembolism may be higher in Asian patients with cirrhosis than in the general Asian population, especially in those with advanced cirrhosis. This article is protected by copyright. All rights reserved.
PMID: 25471737 [PubMed - as supplied by publisher]