P95 Incidence and prevalence of venous thromboembolism in chronic liver disease: systematic review and meta-analysis. (19th June 2022)

• Record Type: Journal Article
• Authors: Subhani, Mohsan; Sheth, Abhishek; Ahmed, Jamal; Wijayasiri, Pramudi; Gardezi, Syed A; Enki, Doyo; Morling, Joanne R; Aithal, Guruprasad P; Ryder, Stephen D; Aravinthan, Aloysious D
• Is Part Of: Gut. Volume 71(2022)Supplement 1
• Page Start: A85
• Page End: A87
• Publication Date: 2022-06-19
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2022-BSG.152
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background and aims: Historically, bleeding was thought to be a frequent and fatal complication of liver disease, thrombosis due to coagulation disorders in cirrhosis remains a real risk. We aim to systematically analyse published articles to evaluate the epidemiology of venous thromboembolism (VTE) in hospitalised patients with chronic liver disease. Method: Electronic search was conducted on Ovid Medline, EMBASE and Scopus from databases inception to 2 nd November 2021. Random effects meta-analysis was performed to determine pooled per-year cumulative incidence, period prevalence, and incidence rate of VTE. Heterogeneity was measured by I² test, and, potential sources of heterogeneity by meta-regression and sub-group analysis. Joanna Briggs Institute's methodological, and MOOSE reporting guidelines were followed. PROSPERO registration-CRD42021239117. Results: Twenty-nine studies comprising 19, 157, 018 participants were included, of which 15, 2049 (0.79%) had VTE. In hospitalised patients with chronic liver disease (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 (I 2 99%, I 2 100%), and publication bias (p<0.0001, p<=0.04) ( figure 1 ). Hospitalised patients with CLD had a pooled relative risk (RR) of 1.55 (95% CI 0.98, 2.45) for VTE compared to those without CLD. Pooled RR in studies reporting incidence rate was 2.11 (95%CI 1.35, 3.31). In two studies (n=1644), patients with CLD who did not receive pharmacological prophylaxis were at significant increased risk of VTE compared to those receiving prophylaxis (RR 2.78, 95% CI 1.11, 6.98). Conclusion: Hospitalised patients with chronic liver disease may be at an increased risk of VTE . For every 1000 hospitalised patients with chronic liver disease ten have new, and eleven have pre-existing diagnoses of venous thromboembolism per year.