Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun;12(3):135-140.
doi: 10.14740/gr1179. Epub 2019 Jun 7.

Elevated International Normalized Ratio: A Risk Factor for Portal Vein Thrombosis in Cirrhotic Patients

Eric Omar Then  1 , Vijay Shailendra Are  2 , Michell Lopez-Luciano  1 , Rani Bijjam  1 , Andrew Ofosu  3 , Andrea Culliford  1 , Vinaya Gaduputi  1
Affiliations

Elevated International Normalized Ratio: A Risk Factor for Portal Vein Thrombosis in Cirrhotic Patients

Eric Omar Then et al. Gastroenterology Res. 2019 Jun.

Abstract

Background: Portal vein thrombosis (PVT) is a complication that is commonly seen in patients with cirrhosis and an entity that leads to increased mortality in patients who undergo liver transplantation. This study aims to establish a link between an elevated international normalized ratio (INR) and the presence of PVT in a cohort of cirrhotic patients.

Methods: We retrospectively reviewed the electronic medical records of all patients diagnosed with cirrhosis in SBH Health System from 2013 to 2018. Among these patients we extracted baseline demographic data, laboratory results, co-morbidities and the presence of PVT.

Results: In total there were 268 patients who met our inclusion criteria. Twenty-two patients had PVT, while 246 patients did not. Of the 22 patients with PVT there was a statistically significant increase in INR when compared to patients without PVT. There was also a statistically significant increase in total bilirubin, alkaline phosphatase and platelet count.

Conclusions: Elevated INR levels are associated with the presence of PVT in patients with cirrhosis. These findings suggest a hypercoagulable state and could assist clinicians in risk-stratifying patients when making the decision to initiate anti-coagulation therapy.

Keywords: Anticoagulation; Cirrhosis; International normalized ratio; Portal vein thrombosis.

PubMed Disclaimer

Conflict of interest statement

None of the authors have any financial conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Mucino-Bermejo J, Carrillo-Esper R, Uribe M, Mendez-Sanchez N. Coagulation abnormalities in the cirrhotic patient. Ann Hepatol. 2013;12(5):713–724. - PubMed
    1. Ponziani FR, Zocco MA, Campanale C, Rinninella E, Tortora A, Di Maurizio L, Bombardieri G. et al. Portal vein thrombosis: insight into physiopathology, diagnosis, and treatment. World J Gastroenterol. 2010;16(2):143–155. doi: 10.3748/wjg.v16.i2.143. - DOI - PMC - PubMed
    1. Rajani R, Bjornsson E, Bergquist A, Danielsson A, Gustavsson A, Grip O, Melin T. et al. The epidemiology and clinical features of portal vein thrombosis: a multicentre study. Aliment Pharmacol Ther. 2010;32(9):1154–1162. doi: 10.1111/j.1365-2036.2010.04454.x. - DOI - PubMed
    1. Qi X, Han G, Fan D. Management of portal vein thrombosis in liver cirrhosis. Nat Rev Gastroenterol Hepatol. 2014;11(7):435–446. doi: 10.1038/nrgastro.2014.36. - DOI - PubMed
    1. Tripodi A, Salerno F, Chantarangkul V, Clerici M, Cazzaniga M, Primignani M, Mannuccio Mannucci P. Evidence of normal thrombin generation in cirrhosis despite abnormal conventional coagulation tests. Hepatology. 2005;41(3):553–558. doi: 10.1002/hep.20569. - DOI - PubMed

LinkOut - more resources