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. 2015 Nov 28;7(27):2774-80.
doi: 10.4254/wjh.v7.i27.2774.

Portal vein thrombosis, mortality and hepatic decompensation in patients with cirrhosis: A meta-analysis

Jonathan G Stine  1 , Puja M Shah  1 , Scott L Cornella  1 , Sean R Rudnick  1 , Marwan S Ghabril  1 , George J Stukenborg  1 , Patrick G Northup  1
Affiliations

Portal vein thrombosis, mortality and hepatic decompensation in patients with cirrhosis: A meta-analysis

Jonathan G Stine et al. World J Hepatol. .

Abstract

Aim: To determine the clinical impact of portal vein thrombosis in terms of both mortality and hepatic decompensations (variceal hemorrhage, ascites, portosystemic encephalopathy) in adult patients with cirrhosis.

Methods: We identified original articles reported through February 2015 in MEDLINE, Scopus, Science Citation Index, AMED, the Cochrane Library, and relevant examples available in the grey literature. Two independent reviewers screened all citations for inclusion criteria and extracted summary data. Random effects odds ratios were calculated to obtain aggregate estimates of effect size across included studies, with 95%CI.

Results: A total of 226 citations were identified and reviewed, and 3 studies with 2436 participants were included in the meta-analysis of summary effect. Patients with portal vein thrombosis had an increased risk of mortality (OR = 1.62, 95%CI: 1.11-2.36, P = 0.01). Portal vein thrombosis was associated with an increased risk of ascites (OR = 2.52, 95%CI: 1.63-3.89, P < 0.001). There was insufficient data available to determine the pooled effect on other markers of decompensation including gastroesophageal variceal bleeding or hepatic encephalopathy.

Conclusion: Portal vein thrombosis appears to increase mortality and ascites, however, the relatively small number of included studies limits more generalizable conclusions. More trials with a direct comparison group are needed.

Keywords: Ascites; Coagulopathy; Hepatic encephalopathy; Hepatology; Liver; Portal hypertension.

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Figures

Figure 1
Figure 1
The preferred reporting items for systematic reviews and meta-analyses diagram. About 226 records were screened in aggregate; 11 full text articles were reviewed; 3 studies met inclusion criteria.
Figure 2
Figure 2
Funnel plot assessing publication bias. No significant publication bias was observed in this study.
Figure 3
Figure 3
Portal vein thrombosis and mortality. PVT is associated with an increased pooled risk of death in the absence of significant heterogeneity. PVT: Portal vein thrombosis.
Figure 4
Figure 4
Portal vein thrombosis and ascites. PVT is associated with an increased pooled risk of hepatic decompensation manifested as ascites. This conclusion may be limited by heterogeneity in the included studies. PVT: Portal vein thrombosis.
See this image and copyright information in PMC

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