Researchers from Paris, France assessed the outcome and predictors of portal vein thrombosis in relation to associated prothrombotic states.
136 adults with nonmalignant, noncirrhotic portal vein thrombosis were enrolled in the study. Of these, 84 received anticoagulant therapy.
Multivariate Cox model analysis was used to calculate event-free survival rates. The median follow-up period was 46 months.
The incidence rate of gastrointestinal bleeding was found to be 12.5 per 100 patient-years. Large varices were an independent predictor for bleeding. Anticoagulant therapy did not increase the risk or the severity of bleeding.
|Incidence rates per 100 patient-years, in patients with portal vein thrombosis:|
Gastrointestinal bleeding: 12.5
Thrombotic events: 5.5
The team found the incidence rate of thrombotic events to be 5.5 per 100 patient-years. Underlying prothrombotic state and absence of anticoagulant therapy were independent predictors for thrombosis.
In patients with underlying prothrombotic state, the incidence rates of splanchnic venous infarction were 0.82 and 5.2 per 100 patient-years in periods with and without anticoagulant therapy, respectively. Two non-anticoagulated patients died of bleeding and thrombosis, respectively.
Researcher Bertrand Condat concluded on behalf of the group, "In patients with portal vein thrombosis, the risk of thrombosis is currently as clinically significant as the risk of bleeding. The benefit-risk ratio favors anticoagulant therapy."