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. 2022 Nov 7:9:1027882.
doi: 10.3389/fmed.2022.1027882. eCollection 2022.

Venous thromboembolism in in-hospital cirrhotic patients: A systematic review

Leonardo da Cruz Renó  1 , Francisco Tustumi  1 , Daniel Reis Waisberg  1 , Vinicius Rocha-Santos  1 , Rafael Soares Pinheiro  1 , Rubens Arantes Macedo  1 , Lucas Souto Nacif  1 , Liliana Ducatti  1 , Rodrigo Bronze De Martino  1 , Alexandre Maximiliano Trevisan  1 , Luiz Carneiro-D'Albuquerque  1 , Wellington Andraus  1
Affiliations

Venous thromboembolism in in-hospital cirrhotic patients: A systematic review

Leonardo da Cruz Renó et al. Front Med (Lausanne). .

Abstract

Introduction: Patients with liver cirrhosis are at a higher risk of hospitalization. The present review aimed to assess the risk of thromboembolism and its burden on hospitalized cirrhotic patients.

Materials and methods: A systematic review (PROSPERO: CRD42021256869) was conducted in PubMed, Embase, Cochrane, Lilacs, and a manual search of references. It evaluated studies that compare cirrhotic patients with venous thromboembolism (VTE) with cirrhotic patients without VTE or studies that compare cirrhotic patients with non-cirrhotic patients. No restrictions were set for the date of publication or language. The last search was conducted in June 2021.

Results: After selection, 17 studies were included from an initial search of 5,323 articles. The chronic liver disease etiologies comprise viral, alcohol, autoimmune, NASH (non-alcoholic steatohepatitis), cryptogenic, hemochromatosis, cholestasis, and drug-related. The included studies were conflicted regarding the outcomes of VTE, pulmonary embolism, or bleeding. Patients with cirrhosis associated with VTE had prolonged length of hospital stay, and patients with cirrhosis were at higher risk of portal thrombosis.

Conclusion: In-hospital cirrhotic patients are a heterogeneous group of patients that may present both thrombosis and bleeding risk. Clinicians should take extra caution to apply both prophylactic and therapeutic anticoagulation strategies.

Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021256869].

Keywords: bleeding; liver; liver cirrhosis; systematic review; venous thrombosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

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FIGURE 1
Selection flow diagram.
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