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
Meta-Analysis
. 2022 Jul:215:19-29.
doi: 10.1016/j.thromres.2022.05.004. Epub 2022 May 17.

Incidence and prevalence of venous thromboembolism in chronic liver disease: A systematic review and meta-analysis

Mohsan Subhani  1 , Abhishek Sheth  2 , Jamal Ahmed  3 , Pramudi Wijayasiri  4 , Syed A Gardezi  5 , Doyo Enki  6 , Joanne R Morling  7 , Guruprasad P Aithal  8 , Stephen D Ryder  9 , Aloysious D Aravinthan  10
Affiliations
Free article
Meta-Analysis

Incidence and prevalence of venous thromboembolism in chronic liver disease: A systematic review and meta-analysis

Mohsan Subhani et al. Thromb Res. 2022 Jul.
Free article

Abstract

Background and aims: Historically, bleeding was thought to be a frequent and fatal complication of liver disease. However, thrombosis due to coagulation disorders in cirrhosis remains a real risk. We aim to systematically analyse published articles to evaluate epidemiology of venous thromboembolism (VTE) in chronic liver disease (CLD).

Method: Electronic search was conducted on Ovid Medline, EMBASE and Scopus from inception to November 2021 to identify studies presenting epidemiology VTE (deep vein thrombosis and pulmonary embolism) in CLD in inpatients and/or community settings. Random-effects meta-analysis was performed to determine pooled per-year cumulative incidence, incidence rate and prevalence. Heterogeneity was measured by I2 test, and, potential sources of heterogeneity by meta-regression and sensitivity analysis. PROSPERO registration-CRD42021239117.

Results: Twenty-nine studies comprising 19,157,018 participants were included, of which 15,2049 (0.79%) had VTE. None of the included studies were done in the community. In hospitalised patients with CLD: pooled cumulative incidence of VTE was 1.07% (95% CI 0.80,1.38) per-year, incidence rate was 157.15 (95% CI 14.74,445.29) per 10,000 person-years, and period prevalence was 1.10% (95% CI 0.85,1.38) per year. There was significant heterogeneity and publication bias. Pooled relative risk (RR) of studies reporting incidence rate was 2.11 (95% CI 1.35,3.31). CLD patients (n = 1644), who did not receive pharmacological prophylaxis were at 2.78 times (95% CI 1.11, 6.98) increased risk of VTE compared to those receiving prophylaxis.

Conclusion: Hospitalised patients with CLD may be at an increased risk of VTE. For every 1000 hospitalised patients with CLD ten have new, and eleven have pre-existing diagnoses of VTE per-year.

Keywords: Chronic liver disease; Deep vein thrombosis; Epidemiology; Incidence; Prevalence; Pulmonary embolism; Systematic review; Venous thromboembolism.

PubMed Disclaimer

LinkOut - more resources