Yang Yong, Zhang Xiao Zhu, Ng Han Seong, Fong Jeffrey Chern Hui, Lee Lai Heng
Department of Epidemiology, Singapore General Hospital, Outram Road, 169608, Singapore; Centre for Quantitative Medicine, Office of Clinical Sciences, Duke-NUS Graduate Medical School, 8 College Road, 169857, Singapore.
Department of Epidemiology, Singapore General Hospital, Outram Road, 169608, Singapore.
Thromb Res. 2015 Sep;136(3):548-51. doi: 10.1016/j.thromres.2015.06.033. Epub 2015 Jul 6.
Chronic liver disease (CLD) has been suggested to be associated with venous thromboembolism (VTE) in western populations. However, little is known about the risk effects of CLD on VTE among Asians.
To compute the prevalence of VTE among hospitalised Asian patients, and to evaluate the pattern and scale of risk effects of CLD on VTE occurrence.
Retrospective study of hospital discharge database from 2004 to 2011 to identify patients with VTE and CLD using International Statistical Classification of Diseases and Related Health Problems, 9th Revision, Australian Modification (ICD-9-AM) codes.
Of 199904 medically managed inpatients during the 8years, 1744 (0.9%) patients had VTE. Patients with CLD had significant higher prevalence of VTE (non-cirrhosis CLD 1.5%, cirrhosis 2.0%) than patients without CLD (0.8%, p<0.001). In the logistic regression analyses, non-cirrhosis CLD (odds ratio, OR 1.4, 95% CI 1.2-1.7, p<0.001) and cirrhosis (OR 1.5, 95% CI 1.2-2.0, p=0.002) were significant predictors of VTE after adjustment for age, gender, ethnicity, hospital long stayer, cancer, infectious disease, and other comorbid conditions such as diabetic mellitus, anaemia, and cardiovascular, cerebrovascular, renal and pulmonary diseases.
CLD, particular liver cirrhosis, increases the risks of VTE in hospitalised Asian patients. As CLD patients are perceived to be at risks of bleeding due to the prolonged clotting times and thrombocytopenia, the results of this study brings attention to opposite end of the haemostatic pendulum in patients with chronic liver disease.
在西方人群中，慢性肝病（CLD）被认为与静脉血栓栓塞症（VTE）有关。然而，关于CLD对亚洲人VTE的风险影响知之甚少。
计算住院亚洲患者中VTE的患病率，并评估CLD对VTE发生的风险影响模式和程度。
对2004年至2011年医院出院数据库进行回顾性研究，使用《国际疾病和相关健康问题统计分类，第9次修订版，澳大利亚修订本》（ICD-9-AM）编码识别VTE和CLD患者。
在8年期间接受医学治疗的199904名住院患者中，1744名（0.9%）患者发生了VTE。CLD患者的VTE患病率（非肝硬化CLD为1.5%，肝硬化为2.0%）显著高于无CLD患者（0.8%，p<0.001）。在逻辑回归分析中，调整年龄、性别、种族、长期住院患者、癌症、传染病以及糖尿病、贫血和心血管、脑血管、肾脏和肺部疾病等其他合并症后，非肝硬化CLD（比值比，OR 1.4，95%CI 1.2-1.7，p<0.001）和肝硬化（OR 1.5，95%CI 1.2-2.0，p=0.002）是VTE的显著预测因素。
CLD，尤其是肝硬化，增加了住院亚洲患者发生VTE的风险。由于CLD患者因凝血时间延长和血小板减少而被认为有出血风险，本研究结果引起了对慢性肝病患者止血平衡另一端的关注。
