The disseminated intravascular coagulation score is a novel predictor for portal vein thrombosis in cirrhotic patients with hepatitis B

ShaoBo Cui; Zhenmei Fu; YueMin Feng; XiaoYu Xie; XiaoWen Ma; TianTian Liu; Le Wang; Hao Wu; Qiang Zhu

doi:10.1016/j.thromres.2017.11.010

The disseminated intravascular coagulation score is a novel predictor for portal vein thrombosis in cirrhotic patients with hepatitis B

Thromb Res. 2018 Jan:161:7-11. doi: 10.1016/j.thromres.2017.11.010. Epub 2017 Nov 15.

Authors

ShaoBo Cui¹, Zhenmei Fu², YueMin Feng², XiaoYu Xie², XiaoWen Ma², TianTian Liu², Le Wang², Hao Wu², Qiang Zhu³

Affiliations

¹ Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China; Department of Gastroenterology, General Hospital of Jincheng Anthracite Coal Mining Group Co. Ltd, Jincheng, Shanxi Province, China.
² Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
³ Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China. Electronic address: zhuqiang@medmail.com.cn.

PMID: 29178991
DOI: 10.1016/j.thromres.2017.11.010

Abstract

Background: The development of portal vein thrombosis (PVT) in cirrhotic patients has not been fully elucidated. The disseminated intravascular coagulation (DIC) score, which is based on readily available and relatively inexpensive coagulation parameters, including platelet count, fibrin-related markers, prothrombin time and fibrinogen, has not been reported regarding PVT development in cirrhotic patients to date. We aimed to evaluate the prognostic value of the DIC score in predicting PVT development in cirrhotic patients with hepatitis B.

Material and methods: A total of 109 cirrhotic patients with hepatitis B were included. Clinical data, laboratory tests and imaging were collected from the patients at baseline and every three months after enrollment. All patients were followed until the study endpoint (either occurrence of PVT or 12months after baseline). We measured routine laboratory parameters and conducted imaging examinations in cirrhotic patients and evaluated the prognostic value of the DIC score as a novel predictor for PVT in patients with cirrhosis. We also compared the effectiveness of the DIC score with other common coagulation and hemodynamic parameters.

Results: Among the 109 patients, 14 (12.8%) developed PVT. At the study endpoint, significant increases in D-dimer, Child-Pugh score and DIC score (all P<0.001) and significantly reduced portal flow velocity (P<0.001) were noted in the PVT group. Among the selected factors, the DIC score had the largest area under the curve (AUC) (0.845), followed by the Child-Pugh score (0.778), D-dimer (0.732), and portal vein velocity (0.709).

Conclusion: Among the selected factors, the DIC score showed non-significantly higher diagnostic performance in predicting the PVT development in cirrhotic patients compared with other factors. A validation cohort of the study is needed in the near future.

Keywords: Cirrhosis; Disseminated intravascular coagulation score; Hepatitis B; Portal vein thrombosis; Predictor.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Disseminated Intravascular Coagulation / complications*
Female
Fibrosis / complications*
Hepatitis B / complications*
Humans
Male
Middle Aged
Prognosis
Prospective Studies
Venous Thrombosis / diagnosis*