Despite the endogenous coagulopathy of cirrhosis, some patients with cirrhosis experience thrombophilic states.
Dr Patrick Northup and colleagues from Virginia determined the incidence and predictors of venous thromboembolism.
The research team assessed deep vein thrombosis, and pulmonary embolism, in hospitalized patients with cirrhosis.
The team performed a retrospective case-control study in a tertiary-care teaching hospital over an 8-year period.
A total of 113 hospitalized patients with cirrhosis with a documented new venous thromboembolism were compared to controls.
The team determined risk factors for venous thromboembolism using univariate and multivariate statistical analyses.
Less than 1% of all hospitalized patients with cirrhosis had a venous thromboembolism.
|Less than 1% of admissions resulted in a thromboembolic event|
|American Journal of Gastroenterology|
The team found that traditional markers of coagulation such as international normalized ratio, and platelet count did not predict venous thromboembolism.
In the univariate analysis, serum albumin level was significantly lower in cases than controls.
Using multivariate analysis, the researchers noted that serum albumin remained independently predictive of venous thromboembolism, with an odds ratio of about 0.3.
Dr Northup's team concludes, “Approximately 1% of admissions involving cirrhosis patients resulted in a new thromboembolic event.”
“Low serum albumin was strongly predictive of increased risk for developing venous thromboembolism, independent of international normalized ratio or platelet count.”
“Serum albumin deficiency may indicate low levels of endogenous anticoagulants.”