Risks of venous thromboembolism in patients with liver cirrhosis: a nationwide cohort study in Taiwan.
BACKGROUND
The results of various studies attempting to assess the risks of venous thromboembolism in liver cirrhosis have been conflicting. Furthermore, although the incidence of venous thromboembolism is thought to be low in Asians, the relationship between venous thromboembolism and liver cirrhosis has not been investigated in Asian countries.


OBJECTIVE
We investigated the risks of venous thromboembolism in cirrhotic patients in Taiwan to evaluate whether the risk is higher than in the general population.


METHODS
The data from 1,000,000 National Health Insurance beneficiaries were utilized. All adult beneficiaries were followed from 1 January 2007 to 31 December 2010 to identify those who developed venous thromboembolism. Each identified patient with liver cirrhosis was matched with 10 non-cirrhotic patients on the basis of high-dimensional propensity score. Cox regression models were applied to compare the hazards of venous thromboembolism in the matched cohorts.


RESULTS
A total of 757,940 patients were enrolled. After matching, 2223 cirrhotic patients and 22,230 non-cirrhotic patients were selected. The adjusted hazard ratio of venous thromboembolism was significantly increased by having cirrhosis (1.71; 95% confidence interval [CI] 1.05-2.78). A subgroup analysis revealed a much higher hazard ratio of venous thromboembolism in an advanced cirrhosis subgroup (n = 293) than in a matched non-cirrhosis subgroup (n = 2930) (4.36; 95% CI 1.36-14.01).


CONCLUSION
The risk of venous thromboembolism may be higher in Asian patients with cirrhosis than in the general Asian population, especially in those with advanced cirrhosis.
['Ng|K-J|KJ|', 'Lee|Y-K|YK|', 'Huang|M-Y|MY|', 'Hsu|C-Y|CY|', 'Su|Y-C|YC|']
D000328:Adult D000368:Aged D044466:Asians D016022:Case-Control Studies D016009:Chi-Square Distribution D015331:Cohort Studies D016208:Databases, Factual D005260:Female D006801:Humans D053208:Kaplan-Meier Estimate D008103:Liver Cirrhosis D008297:Male D008875:Middle Aged D016017:Odds Ratio D057216:Propensity Score D016016:Proportional Hazards Models D018570:Risk Assessment D012307:Risk Factors D013624:Taiwan D054556:Venous Thromboembolism
venous thromboembolism liver cirrhosis cohort studies pulmonary embolism venous thrombosis