Predicting the risk of variceal rehemorrhage in cirrhotic patients with portal vein thrombosis: A two‐center retrospective study

Objectives Although portal vein thrombosis (PVT) was thought to deteriorate portal hypertension and contribute to poor prognosis, risk stratification remains unclear. This study aimed to evaluate its effect on the risk of variceal rehemorrhage and to develop a competitive risk model in cirrhotic pat...

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Bibliographic Details
Published in:Journal of digestive diseases 2023-11, Vol.24 (11), p.619-629
Main Authors: Zhang, Shuo, Zhong, Xuan, Zhong, Hui, Zhong, Lan, Li, Jing, Zhu, Feng Shang, Xia, Lu, Yang, Chang Qing
Format: Article
Language:English
Subjects:
Aspartate aminotransferase
Cirrhosis
Competition
Decision making
Esophageal and Gastric Varices - complications
Gastrointestinal Hemorrhage - complications
Hemorrhage
Humans
Liver Cirrhosis - pathology
portal hypertension
Portal vein
Portal Vein - pathology
portal vein thrombosis
Regression analysis
Retrospective Studies
Risk Factors
Thrombosis
variceal rehemorrhage
Venous Thrombosis - complications
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Summary:Objectives Although portal vein thrombosis (PVT) was thought to deteriorate portal hypertension and contribute to poor prognosis, risk stratification remains unclear. This study aimed to evaluate its effect on the risk of variceal rehemorrhage and to develop a competitive risk model in cirrhotic patients with PVT. Methods Cirrhotic patients with and without PVT admitted for acute variceal hemorrhage were retrospectively included after matching (1:1) for age, gender and etiology of cirrhosis from two tertiary centers with 1‐year follow‐up. Those with PVT were subsequently divided into the training and validation cohorts. Cox regression analysis was performed to identify risk factors and develop a competitive risk model, of which the predictive performance and optimal decision threshold were evaluated by C‐index, competitive risk curves, calibration curves and decision curve analysis. Results Among 398 patients, PVT significantly increased the variceal rehemorrhage risk. Multivariate Cox regression analysis identified that the Child–Turcotte–Pugh score (P = 0.013), chronic PVT (P = 0.025), C‐reactive protein (P 
ISSN:1751-2972
1751-2980
DOI:10.1111/1751-2980.13239