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Risks of venous thromboembolism in patients with liver cirrhosis: a nationwide cohort study in Taiwan
Author(s) -
Ng K.J.,
Lee Y.K.,
Huang M.Y.,
Hsu C.Y.,
Su Y.C.
Publication year - 2015
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12805
Subject(s) - medicine , cirrhosis , hazard ratio , confidence interval , population , subgroup analysis , propensity score matching , incidence (geometry) , proportional hazards model , cohort study , environmental health , physics , optics
Summary 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.