studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 943A
1501
Portal vein thrombosis, mortality and hepatic decompensation
in patients with cirrhosis: A meta-analysis
Jonathan G. Stine 1 , Puja M. Shah 2 , Scott L. Cornella 3 , Sean R.
Rudnick 1 , George R. Stukenborg 4 , Patrick Northup 1 ; 1 Gastroenterology
& Hepatology, University of Virginia, Charlottesville, VA;
2 Surgery, University of Virginia, Charlottesville, VA; 3 Medicine,
University of Virginia, Charlottesville, VA; 4 Public Health Sciences,
University of Virginia, Charlottesville, VA
Background: Non-neoplastic portal vein thrombosis is a common
complication of cirrhosis. Treatment options can be risky
and are not without complications. To make the most appropriate
choice, clinicians need to know what the evidence
says about the clinical importance of portal vein thrombosis
in patients with cirrhosis. Objectives: To determine the clinical
impact of portal vein thrombosis in terms of both mortality
and hepatic decompensation (variceal hemorrhage, ascites,
portosystemic encephalopathy) in adult patients with cirrhosis.
Methods: We identified observational research studies
through February 2015 from MEDLINE, EMBASE, Scopus, Science
Citation Index, AMED, Google Scholar, the Cochrane
Library and the relevant grey literature. Two independent
reviewers screened citations and extracted data. We specifically
excluded any studies involving liver transplantation. We
graded the strength of evidence and determined the magnitude
of effect by calculating DerSimonian and Laird random effects
odds ratios to obtain aggregate estimates of effect size and
95% confidence intervals. Between-study variability and heterogeneity
were assessed. Main results: After reviewing 226
citations, we included 3 studies with 2,436 participants. The
majority of included patients were Caucasian. Viral hepatitis
was the most common etiology of cirrhosis (42%) and alcoholic
liver disease was the second most prevalent (21%). Median
MELD scores ranged from 10-15 for each individual study. The
prevalence of portal vein thrombosis in aggregate was 7.2%.
Patients with portal vein thrombosis had an increased risk of
mortality (OR 1.69, 95% CI 1.18-2.42, p