Frequency of Venous Thromboembolism in Patients with Liver Cirrhosis

Introduction The major hemostatic problem in cirrhotic patients is the increased risk of bleeding, but venous thromboembolism is also being reported as a noticeable feature of cirrhosis. Therefore, we conducted this study to determine the frequency of venous thromboembolism in patients with liver cirrhosis. Materials and methods This cross-sectional study took place at a major metropolitan hospital in Karachi for a period of six months. A total of 142 patients age 40 to 70 years, either gender and Child-Pugh class A to C liver cirrhosis for >3 months were enrolled in this study. The demographic features like age, gender, weight, height, body mass index (BMI), duration of symptoms, and Child-Pugh class were noted. The patients were examined for calf swelling, tenderness, and pitting edema. Venous thrombosis was diagnosed on ultrasound of the calf done by an experienced radiologist in patients having two or more than two of the above-stated findings. The mean and standard deviation were calculated for age, weight, height, body mass index (BMI), and duration of symptoms. The frequency and percentage were calculated for the range of age, gender, range of weight, range of height, range of BMI, range of duration of symptoms, Child-Pugh class, and venous thrombosis. Stratification was done of venous thrombosis with age, obesity, gender, Child-Pugh class, and duration of symptoms by applying the chi-square test and assuming p-value ≤0.05 as significant. Results The mean age of the study population was 60.73 ± 10.83 years and most patients, i.e., 95 (66.9%) were >60 years. There were 89 (62.7%) female and 53 (37.3%) male patients. The mean weight of the study population was 60.15 ± 5.11 kg and most patients, i.e., 81 (57%), weighed ≤60 kg. The mean height of the study population was 1.53 ± 0.59 m and most patients, i.e., 99 (69.7%) were ≤1.5 m. The mean BMI of the study population was 27.24 ± 5.02 kg/m2 and most patients, i.e., 81 (57%) were ≤30 kg/m2. The mean duration of symptoms of the patients was 5.63 ± 1.77 months and most patients, i.e., 86 (60.6%) had ≤6 months of duration of symptoms. Eighty-six (60.56%) patients had Child-Pugh class A, 39 (27.47%) patients had Child-Pugh class B, and 17 (11.97%) patients had Child-Pugh class C liver cirrhosis. Ten (7%) of the patients had venous thrombosis. Stratification of venous thrombosis with age, gender, obesity, Child-Pugh class, and duration of symptoms showed a significant linear relationship with gender (p-value= 0.040), obesity (p-value= 0.043), and Child-Pugh class (p-value= 0.001). Conclusions Venous thromboembolism is a frequent complication and a pathogenic factor in liver cirrhosis that should be given attention to in cirrhotic patients especially in male and obese patients of Child-Pugh class B and C. Low serum albumin and increased partial thromboplastin time (PTT) can have some role in its prediction and early prevention. But more studies are needed to establish this.