caa a22 4500 445794453 CHVBK 20180317145120.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s10620-011-1582-5 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1582-5 Deep Vein Thrombosis and Pulmonary Embolism in Hospitalized Patients with Cirrhosis: A Nationwide Analysis [Elektronische Daten] [Muhammad Ali, Ashwin Ananthakrishnan, Emily McGinley, Kia Saeian] Background and Aims: Recent studies have shown conflicting results regarding the risk of venous thromboembolism (VTE) in cirrhotics despite the often-associated coagulopathy. Our aim was to determine burden and risk factors for VTE in cirrhotics from a national sample. Methods: Using data from the Nationwide Inpatient Sample 2005, we identified cirrhosis-related hospitalizations using appropriate discharge codes. Our outcomes of interest were deep venous thrombosis (DVT) or pulmonary embolism (PE). Cirrhotics without VTE formed the controls. Multivariate regression models were used to identify factors independently associated with VTE and the impact of VTE diagnosis on in-hospital outcomes. Results: There were 449,798 hospitalizations for cirrhosis in 2005 of which 8,231 were for VTE (1.8%). This rate was lower than the rate for chronic hepatitis C (2.4%) or all-cause hospitalizations (3.7%). Patients with VTE were older than controls and had greater co-morbidity and were more likely to have malnutrition, parenteral nutrition, prolonged mechanical ventilation, and central venous line (CVL) placement. Complications of cirrhosis including hepatic encephalopathy, variceal bleeding, ascites, and coagulopathy were less frequent in those with VTE than controls. On multivariate regression, greater co-morbidity, black race, malnutrition, and CVL placement were independently associated with VTE. Neither DVT nor PE was associated with greater in-hospital mortality. DVT, but not PE, was associated with a 52% increase in LOS and hospitalization charges. Conclusions: Despite the often-associated coagulopathy, VTE contributes to a significant burden in patients with cirrhosis. Efforts directed at VTE prevention in this cohort, especially high-risk patients, should be actively pursued. Springer Science+Business Media, LLC, 2011 Cirrhosis nationallicence Deep vein thrombosis nationallicence Pulmonary embolism nationallicence Coagulopathy nationallicence Risk factors nationallicence CI : Confidence interval nationallicence CVL : Central venous Line nationallicence DVT : Deep vein thrombosis nationallicence ICD-9-CM : International Classification of Disease, Clinical Modification, ninth revision nationallicence LOS : Length of stay nationallicence MELD : Model end-stage liver disease nationallicence NIS : Nationwide Inpatient Sample nationallicence OR : Odds ratio nationallicence PE : Pulmonary embolism nationallicence SBP : Spontaneous bacterial peritonitis nationallicence TPN : Total parenteral nutrition nationallicence VTE : Venous thromboembolism nationallicence Ali Muhammad Department of Medicine, Medical College of Wisconsin, 53226, Milwaukee, WI, USA aut Ananthakrishnan Ashwin Department of Gastroenterology and Hepatology, Medical College of Wisconsin, 53226, Milwaukee, WI, USA aut McGinley Emily Department of Population Health, Medical College of Wisconsin, 53226, Milwaukee, WI, USA aut Saeian Kia Department of Gastroenterology and Hepatology, Medical College of Wisconsin, 53226, Milwaukee, WI, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/7(2011-07-01), 2152-2159 0163-2116 56:7<2152 2011 56 10620 https://doi.org/10.1007/s10620-011-1582-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1582-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ali Muhammad Department of Medicine, Medical College of Wisconsin, 53226, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Ananthakrishnan Ashwin Department of Gastroenterology and Hepatology, Medical College of Wisconsin, 53226, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- McGinley Emily Department of Population Health, Medical College of Wisconsin, 53226, Milwaukee, WI, USA aut NATIONALLICENCE 700 1- Saeian Kia Department of Gastroenterology and Hepatology, Medical College of Wisconsin, 53226, Milwaukee, WI, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/7(2011-07-01), 2152-2159 0163-2116 56:7<2152 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer