| Related Articles |
Safety and Efficacy of Pharmacological Thromboprophylaxis for Hospitalized Patients with Cirrhosis: A Single-Center Retrospective Cohort Study.
J Thromb Haemost. 2015 May 7;
Authors: Shatzel J, Dulai PS, Harbin D, Cheung H, Reid T, Kim J, James SL, Khine H, Batman S, Whyman J, Dickson RC, Ornstein DL
Abstract
BACKGROUND: Hospitalized patients with cirrhosis are at increased risk for venous thromboembolism (VTE). The benefits and risks of pharmacological thromboprohylaxis in these patients have not been well studied.
OBJECTIVES: To examine the safety and efficacy of pharmacological VTE prophylaxis in hospitalized cirrhotic patients.
PATIENTS/METHODS: Retrospective cohort study of patients with cirrhosis hospitalized at an academic tertiary care referral center over a 5-year period.
RESULTS: 600 hospital admissions accounting for 402 patients were included. VTE prophylaxis was administered during 296 (49%) admissions. Patients receiving VTE prophylaxis were older (59 years vs. 55 years, p < 0.001), had longer lengths of stay (9.6 days vs. 6.8 days, p = 0.002), and lower MELD scores (13.2 vs. 16.1, p < 0.001). In-hospital bleeding events (8.1 vs. 5.5%, p = 0.258), GI-bleeding events (3.0 vs. 3.2% p = 0.52), new VTE events (2.37 vs. 1.65%, p = 0.537), and mortality (8.4 vs. 7.3%, p = 0.599) were similar in the two groups. VTE prophylaxis did not reduce the risk of VTE (OR 0.94, 95% CI 0.23 - 3.71), and patients receiving unfractionated heparin (UFH), but not low molecular weight heparin (LMWH), were at increased risk for in-hospital bleeding events (OR 2.38, 95% CI 1.15 - 4.94 vs. OR 0.87, 95% CI 0.37 - 2.05, respectively).
CONCLUSION: The rate of VTE in this cohort of hospitalized cirrhotic patients was low and was unaffected by pharmacological thromboprophylaxis. UFH was associated with an increased risk for in-hospital bleeding, suggesting that if thromboprophylaxis is indicated, LMWH may be favored. This article is protected by copyright. All rights reserved.
PMID: 25955079 [PubMed - as supplied by publisher]