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Risk Factors, Clinical Presentation, Diagnosis, and Treatment Outcomes of Portal Vein Thrombosis: A Five-Year Hospital-Based Study From Qatar
BACKGROUND: There is a lack of robust epidemiological information on portal vein thrombosis (PVT) in Qatar. This study aimed to describe the risk factors, clinical presentation, diagnosis, and treatment outcomes of PVT in patients with and without liver cirrhosis admitted to Hamad General Hospital....
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187352/ https://www.ncbi.nlm.nih.gov/pubmed/35720227 http://dx.doi.org/10.14740/jocmr4718 |
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author | Khan, Fahmi Yousef Habas, Elmukhtar Sulaiman, Theeb Osama Hamid, Omnia A. Abdalhadi, Ahmed Khalaf, Ahmad Afana, Mohammed S. Ali, Mohamed Yousif Baniamer, Yahia Zakaria Kanjo, Wael Muthanna, Bassam Akbar, Raza Ali |
author_facet | Khan, Fahmi Yousef Habas, Elmukhtar Sulaiman, Theeb Osama Hamid, Omnia A. Abdalhadi, Ahmed Khalaf, Ahmad Afana, Mohammed S. Ali, Mohamed Yousif Baniamer, Yahia Zakaria Kanjo, Wael Muthanna, Bassam Akbar, Raza Ali |
author_sort | Khan, Fahmi Yousef |
collection | PubMed |
description | BACKGROUND: There is a lack of robust epidemiological information on portal vein thrombosis (PVT) in Qatar. This study aimed to describe the risk factors, clinical presentation, diagnosis, and treatment outcomes of PVT in patients with and without liver cirrhosis admitted to Hamad General Hospital. METHODS: This retrospective observational study was conducted at Hamad General Hospital, Doha, Qatar. Consecutive patients with PVT between January 1, 2015 and December 31, 2019 were included in this study. RESULTS: We included 363 cases representing 0.05% of all inpatients admitted to our hospital during the study period. Their mean age was 47.79 ± 14.48 years. There were 258 (71.1%) males and 105 (28.9%) females. Abdominal pain was the most common presenting symptom (160 (44.1%)), while splenomegaly was the most common presenting sign (158 (43.5%)). Liver cirrhosis was the most frequent risk factor for PVT (147 (40.5%)), while no risk factors were identified in 49 (13.5%) patients. Anticoagulant therapy was given to 171/207 (82.6%) patients with acute PVT and 19/156 (12.2%) patients with chronic PVT. The options used for anticoagulation treatment were: low molecular weight heparin (LMWH) or unfractionated heparin alone, LMWH/unfractionated heparin followed by warfarin, and direct-acting oral anticoagulants (rivaroxaban). Out of the 262 patients in whom PVT recanalization was assessed, 43.8% of the cases had recanalization after anticoagulation treatment, while 12.6% of them had spontaneous recanalization without such therapy. A comparison between different anticoagulants used in this study showed no significant difference in the effectiveness of the three regimens used. The 30-day mortality was recorded for 71 patients (19.5%). The major risk factors for 30-day mortality were: age over 45 years, male sex, hepatic failure, malignancies, and bilirubin > 34 µmol/L. CONCLUSION: PVT is a rare clinical entity in Qatar with liver cirrhosis being the most common risk factor. Early administration of anticoagulation therapy is associated with a significant recanalization, while age > 45 years, male sex, hepatic failure, malignancies, and bilirubin > 34 µmol/L are independent risk factors for 30-day mortality. |
format | Online Article Text |
id | pubmed-9187352 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-91873522022-06-17 Risk Factors, Clinical Presentation, Diagnosis, and Treatment Outcomes of Portal Vein Thrombosis: A Five-Year Hospital-Based Study From Qatar Khan, Fahmi Yousef Habas, Elmukhtar Sulaiman, Theeb Osama Hamid, Omnia A. Abdalhadi, Ahmed Khalaf, Ahmad Afana, Mohammed S. Ali, Mohamed Yousif Baniamer, Yahia Zakaria Kanjo, Wael Muthanna, Bassam Akbar, Raza Ali J Clin Med Res Original Article BACKGROUND: There is a lack of robust epidemiological information on portal vein thrombosis (PVT) in Qatar. This study aimed to describe the risk factors, clinical presentation, diagnosis, and treatment outcomes of PVT in patients with and without liver cirrhosis admitted to Hamad General Hospital. METHODS: This retrospective observational study was conducted at Hamad General Hospital, Doha, Qatar. Consecutive patients with PVT between January 1, 2015 and December 31, 2019 were included in this study. RESULTS: We included 363 cases representing 0.05% of all inpatients admitted to our hospital during the study period. Their mean age was 47.79 ± 14.48 years. There were 258 (71.1%) males and 105 (28.9%) females. Abdominal pain was the most common presenting symptom (160 (44.1%)), while splenomegaly was the most common presenting sign (158 (43.5%)). Liver cirrhosis was the most frequent risk factor for PVT (147 (40.5%)), while no risk factors were identified in 49 (13.5%) patients. Anticoagulant therapy was given to 171/207 (82.6%) patients with acute PVT and 19/156 (12.2%) patients with chronic PVT. The options used for anticoagulation treatment were: low molecular weight heparin (LMWH) or unfractionated heparin alone, LMWH/unfractionated heparin followed by warfarin, and direct-acting oral anticoagulants (rivaroxaban). Out of the 262 patients in whom PVT recanalization was assessed, 43.8% of the cases had recanalization after anticoagulation treatment, while 12.6% of them had spontaneous recanalization without such therapy. A comparison between different anticoagulants used in this study showed no significant difference in the effectiveness of the three regimens used. The 30-day mortality was recorded for 71 patients (19.5%). The major risk factors for 30-day mortality were: age over 45 years, male sex, hepatic failure, malignancies, and bilirubin > 34 µmol/L. CONCLUSION: PVT is a rare clinical entity in Qatar with liver cirrhosis being the most common risk factor. Early administration of anticoagulation therapy is associated with a significant recanalization, while age > 45 years, male sex, hepatic failure, malignancies, and bilirubin > 34 µmol/L are independent risk factors for 30-day mortality. Elmer Press 2022-05 2022-05-31 /pmc/articles/PMC9187352/ /pubmed/35720227 http://dx.doi.org/10.14740/jocmr4718 Text en Copyright 2022, Khan et al. https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Khan, Fahmi Yousef Habas, Elmukhtar Sulaiman, Theeb Osama Hamid, Omnia A. Abdalhadi, Ahmed Khalaf, Ahmad Afana, Mohammed S. Ali, Mohamed Yousif Baniamer, Yahia Zakaria Kanjo, Wael Muthanna, Bassam Akbar, Raza Ali Risk Factors, Clinical Presentation, Diagnosis, and Treatment Outcomes of Portal Vein Thrombosis: A Five-Year Hospital-Based Study From Qatar |
title | Risk Factors, Clinical Presentation, Diagnosis, and Treatment Outcomes of Portal Vein Thrombosis: A Five-Year Hospital-Based Study From Qatar |
title_full | Risk Factors, Clinical Presentation, Diagnosis, and Treatment Outcomes of Portal Vein Thrombosis: A Five-Year Hospital-Based Study From Qatar |
title_fullStr | Risk Factors, Clinical Presentation, Diagnosis, and Treatment Outcomes of Portal Vein Thrombosis: A Five-Year Hospital-Based Study From Qatar |
title_full_unstemmed | Risk Factors, Clinical Presentation, Diagnosis, and Treatment Outcomes of Portal Vein Thrombosis: A Five-Year Hospital-Based Study From Qatar |
title_short | Risk Factors, Clinical Presentation, Diagnosis, and Treatment Outcomes of Portal Vein Thrombosis: A Five-Year Hospital-Based Study From Qatar |
title_sort | risk factors, clinical presentation, diagnosis, and treatment outcomes of portal vein thrombosis: a five-year hospital-based study from qatar |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187352/ https://www.ncbi.nlm.nih.gov/pubmed/35720227 http://dx.doi.org/10.14740/jocmr4718 |
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