Portal vein thrombosis, mortality and hepatic decompensation in patients with cirrhosis: A meta-analysis

AIM: To determine the clinical impact of portal vein thrombosis in terms of both mortality and hepatic decompensations(variceal hemorrhage, ascites, portosystemic encephalopathy) in adult patients with cirrhosis.METHODS: We identified original articles reported through February 2015 in MEDLINE, Scop...

Full description

Saved in:
Bibliographic Details
Published inWorld journal of hepatology Vol. 7; no. 27; pp. 2774 - 2780
Main Authors Stine, Jonathan G, Shah, Puja M, Cornella, Scott L, Rudnick, Sean R, Ghabril, Marwan S, Stukenborg, George J, Northup, Patrick G
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 28.11.2015
Subjects
ence
Hepatology;Coagulopathy;Liver;Ascites;Hepatic
Meta-Analysis
Ascites
Hepatology
Liver
Coagulopathy
Hepatic encephalopathy
Portal hypertension
Online AccessGet full text

Cover

More Information
Summary:AIM: To determine the clinical impact of portal vein thrombosis in terms of both mortality and hepatic decompensations(variceal hemorrhage, ascites, portosystemic encephalopathy) in adult patients with cirrhosis.METHODS: We identified original articles reported through February 2015 in MEDLINE, Scopus, Science Citation Index, AMED, the Cochrane Library, and relevant examples available in the grey literature. Two independent reviewers screened all citations for inclusion criteria and extracted summary data. Random effects odds ratios were calculated to obtain aggregate estimates of effect size across included studies, with 95%CI.RESULTS: A total of 226 citations were identified and reviewed, and 3 studies with 2436 participants were included in the meta-analysis of summary effect. Patients with portal vein thrombosis had an increased risk of mortality(OR = 1.62, 95%CI: 1.11-2.36, P = 0.01). Portal vein thrombosis was associated with an increased risk of ascites(OR = 2.52, 95%CI: 1.63-3.89, P < 0.001). There was insufficient data available to determine the pooled effect on other markers of decompensation including gastroesophageal variceal bleeding or hepatic encephalopathy. CONCLUSION: Portal vein thrombosis appears to increase mortality and ascites, however, the relatively small number of included studies limits more generalizable conclusions. More trials with a direct comparison group are needed.
Bibliography:Hepatology;Coagulopathy;Liver;Ascites;Hepatic ence
AIM: To determine the clinical impact of portal vein thrombosis in terms of both mortality and hepatic decompensations(variceal hemorrhage, ascites, portosystemic encephalopathy) in adult patients with cirrhosis.METHODS: We identified original articles reported through February 2015 in MEDLINE, Scopus, Science Citation Index, AMED, the Cochrane Library, and relevant examples available in the grey literature. Two independent reviewers screened all citations for inclusion criteria and extracted summary data. Random effects odds ratios were calculated to obtain aggregate estimates of effect size across included studies, with 95%CI.RESULTS: A total of 226 citations were identified and reviewed, and 3 studies with 2436 participants were included in the meta-analysis of summary effect. Patients with portal vein thrombosis had an increased risk of mortality(OR = 1.62, 95%CI: 1.11-2.36, P = 0.01). Portal vein thrombosis was associated with an increased risk of ascites(OR = 2.52, 95%CI: 1.63-3.89, P < 0.001). There was insufficient data available to determine the pooled effect on other markers of decompensation including gastroesophageal variceal bleeding or hepatic encephalopathy. CONCLUSION: Portal vein thrombosis appears to increase mortality and ascites, however, the relatively small number of included studies limits more generalizable conclusions. More trials with a direct comparison group are needed.
Jonathan G Stine;Puja M Shah;Scott L Cornella;Sean R Rudnick;Marwan S Ghabril;George J Stukenborg;Patrick G Northup;Division of Gastroenterology and Hepatology, University of Virginia;Department of Surgery, University of Virginia;Department of Medicine, University of Virginia;Division of Gastroenterology and Hepatology,Indiana University;Department of Public Health Science, University of Virginia
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
Telephone: +1-434-9242959 Fax: +1-434-2447529
Author contributions: Stine JG and Shah PM contributed equally to this work; Stine JG, Shah PM, Ghabril MS, Stukenborg GJ and Northup PG designed research; Stine JG, Shah PM, Cornella SL and Rudnick SR performed research; Stine JG and Shah PM analyzed data; Stine JG, Shah PM, Cornella SL, Rudnick SR, Ghabril MS, Stukenborg GJ and Northup PG wrote the paper.
Correspondence to: Jonathan G Stine, MD, MSc, Division of Gastroenterology and Hepatology, University of Virginia, JPA and Lee Street, MSB 2145, PO Box 800708, Charlottesville, VA 22908, United States. jgs9f@virginia.edu
ISSN:1948-5182
1948-5182
DOI:10.4254/wjh.v7.i27.2774