Characteristics,Risk Factors And Prognosis Of Portal Vein Thrombosis(PVT)in Patients With Cirrhosis And Acute Decompensation(AD)

Background & Aims: Portal vein thrombosis(PVT)is a common and serious complication in patients with cirrhosis.However,little is known about PVT in patients with cirrhosis and acute decompensation(AD).We investigated the prevalence and clinical significance of nonmalignant PVT in patients with cirrhosis and AD.Methods: Patients came from two prospective multicenter cohorts of patients with acute exacerbation of chronic liver disease,named CATCHLIFE,established by the Chinese Chronic Liver Failure Consortium from January 2015 to December 2016(n=2600,NCT02457637)and July 2018 to January 2019(n=1370,NCT03641872).The prevalence,clinical manifestations and risk factors of PVT in patients with cirrhosis and AD were analyzed.Results: The prevalence of PVT in patients with cirrhosis and AD,was9.36%,significantly higher than those with cirrhosis without AD(5.24%)(p=0.04).Among patients with cirrhosis and AD,PVT mostly occurred recently(63.37%).Compared to patients without PVT,patients with PVT had a significantly higher incidence of variceal bleeding(47.33% vs 19.63%,p<0.001)and a higher serum level of D-dimer(2.07 vs 1.25;p<0.001).Splenectomy and endoscopic sclerotherapy were independent risk factors for PVT in patients with cirrhosis and AD.And among patients with cirrhosis and AD,the short-term and long-term mortality rate did not statistically significant differ between patients with PVT and those without PVT.Conclusions: Patients with cirrhosis and AD had a significant elevated prevalence of PVT.The occurrence of PVT promoted portal hypertension and variceal bleeding,thus would increase the risk for mortality as a result of the development of AD.It would be beneficial to improve portal hypertension through regular screening and preventing PVT in patients with cirrhosis.