Dataset Information

Cirrhosis is Associated with an Increased 30-Day Mortality After Venous Thromboembolism.

ABSTRACT:

Objectives

Patients with cirrhosis are at increased risk of venous thromboembolism (VTE), but the impact of cirrhosis on the clinical course following VTE is unclear. In a nationwide cohort study, we examined 30-day mortality among patients with cirrhosis and VTE.

Methods

We used Danish population-based health-care databases (1994-2011) to identify patients with incident VTE, i.e., deep venous thrombosis (DVT), pulmonary embolism (PE), and portal vein thrombosis (PVT). Among these, we identified 745 patients with cirrhosis and 3647 patients without cirrhosis (matched on gender, year of birth, calendar year of VTE diagnosis and VTE type). We assessed the 30-day mortality risk among VTE patients with and without cirrhosis, and the mortality rate ratios (MRRs), using an adjusted Cox model with 95% confidence interval. We obtained information on immediate cause of death for patients who died within 30 days after VTE.

Results

The 30-day mortality risk for DVT was 7% for patients with cirrhosis and 3% for patients without cirrhosis. Corresponding PE-related mortality risks were 35% and 16%, and PVT-related mortality risks were 19% and 15%, respectively. The adjusted 30-day MRRs were 2.17 (1.24-3.79) for DVT, 1.83 (1.30-2.56) for PE, and 1.30 (0.80-2.13) for PVT. Though overall mortality was higher in patients with cirrhosis than patients without cirrhosis, the proportions of deaths due to PE were similar among patients (25% and 24%, respectively).

Conclusions

Cirrhosis is a predictor for increased short-term mortality following VTE, with PE as the most frequent cause of death.

SUBMITTER: Sogaard KK

PROVIDER: S-EPMC4816257 | biostudies-literature | 2015 Jul

REPOSITORIES: biostudies-literature

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Publications

Cirrhosis is Associated with an Increased 30-Day Mortality After Venous Thromboembolism.

Søgaard Kirstine Kobberøe KK Horváth-Puhó Erzsébet E Montomoli Jonathan J Vilstrup Hendrik H Sørensen Henrik Toft HT

Clinical and translational gastroenterology 20150702

<h4>Objectives</h4>Patients with cirrhosis are at increased risk of venous thromboembolism (VTE), but the impact of cirrhosis on the clinical course following VTE is unclear. In a nationwide cohort study, we examined 30-day mortality among patients with cirrhosis and VTE.<h4>Methods</h4>We used Danish population-based health-care databases (1994-2011) to identify patients with incident VTE, i.e., deep venous thrombosis (DVT), pulmonary embolism (PE), and portal vein thrombosis (PVT). Among these ...[more]

PMID: 26133110

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Project description:AimsNorepinephrine is recommended as a first-line vasopressor agent in the haemodynamic stabilization of cardiogenic shock. The survival benefit of norepinephrine therapy has not been demonstrated in clinical practice, however. This study aimed to explore the relationship between norepinephrine use and outcomes in cardiogenic shock patients in real-world conditions.Methods and resultsWe conducted a retrospective cohort study based on the Medical Information Mart for Intensive Care III (MIMIC-III) database. Cardiogenic shock patients were enrolled and categorized into a norepinephrine group or a non-norepinephrine group. Propensity score matching (PSM) was used to control for confounders. Cox proportional-hazards models and multivariable logistic regression were used to investigate the relationship between norepinephrine treatment and mortality. A total of 927 eligible patients were included: 552 patients in the norepinephrine group and 375 patients in the non-norepinephrine group. After PSM, 222 cases from each group were matched using a 1:1 matching algorithm. Thirty day mortality for patients treated with norepinephrine was significantly higher than for those in the non-norepinephrine group (41% vs. 30%, OR 1.61, 95% CI 1.09-2.39, P = 0.017; HR 1.50, 95% CI 1.09-2.06, P = 0.013). In the multivariable analysis, there was no significant difference between norepinephrine therapy and long-term (90 day, 180 day, or 1 year) mortality (90 day (OR 1.19, 95% CI 0.82-1.74, P = 0.363), 180 day (OR 1.17, 95% CI 0.80-1.70, P = 0.418), 1 year (OR 1.14, 95% CI 0.79-1.66, P = 0.477). Patients in the norepinephrine group required more mechanical ventilation (84% vs. 67%, OR 2.67, 95% CI 1.70-4.25, P < 0.001) and experienced longer ICU stays (median 7 vs. 4 days, OR 7.92, 95% CI 1.40-44.83, P = 0.020) than non-norepinephrine group.ConclusionsCardiogenic shock patients treated with norepinephrine were associated with significantly increased short-term mortality, while no significant difference was found on long-term survival rates. Future trials are needed to validate and explore this association.

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Dataset Information

Cirrhosis is Associated with an Increased 30-Day Mortality After Venous Thromboembolism.

Objectives

Methods

Results

Conclusions

Publications

Cirrhosis is Associated with an Increased 30-Day Mortality After Venous Thromboembolism.

Similar Datasets

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