Decreased portal vein velocity is predictive of the development of portal vein thrombosis: A matched case-control study

Jonathan Stine, Jennifer Wang, Puja M. Shah, Curtis K. Argo, Nicolas Intagliata, Andre Uflacker, Stephen H. Caldwell, Patrick G. Northup

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background & Aims: Portal vein thrombosis (PVT) in cirrhosis may lead to hepatic decompensation and increased mortality. We aimed to investigate if decreased portal vein (PV) velocity is associated with future PVT. Methods: Data on adult patients with cirrhosis and PVT between January 1, 2005 and July 30, 2015 were obtained. Cases with PVT were matched by age, gender and Model for End-stage Liver Disease (MELD) score to corresponding controls without PVT. Cox proportional hazards models, receiver operator curves and Kaplan Meier curves were constructed. Results: One hundred subjects (50 matched pairs) with mean age 53.8±13.1 y and MELD score 14.9±5.5 were included in our analysis. Sixty-four percent were male and 76% were Child-Turcotte-Pugh Class A or B. Baseline characteristics (prior to development of PVT) were similar, except for baseline PV velocity (16.9 cm/s, 95% CI 13.9-20.0 PVT vs 25.0, 95% CI 21.8-28.8 no PVT, P<.001). 30 PVT subjects had PV velocity <15 cm/s compared to five without PVT (P<.001). On adjusted multivariable analysis, PV velocity was the strongest independent risk factor predicting PVT development (HR 0.86, 95% CI 0.80-0.93). The predictive value for PVT development was greatest for flow <15 cm/s (c-statistic 0.77). PV velocity <15 cm/s had a highly significant association with future PVT (HR 6.00, 95% CI 2.20-16.40, P=<.001). Conclusions: Decreased PV velocity is associated with increased risk of future PVT. Patients with cirrhosis and decreased PV velocity are a high-risk subgroup that warrants further investigation with prospective study.

Original languageEnglish (US)
Pages (from-to)94-101
Number of pages8
JournalLiver International
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Portal Vein
Case-Control Studies
Thrombosis
End Stage Liver Disease
Fibrosis

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Stine, Jonathan ; Wang, Jennifer ; Shah, Puja M. ; Argo, Curtis K. ; Intagliata, Nicolas ; Uflacker, Andre ; Caldwell, Stephen H. ; Northup, Patrick G. / Decreased portal vein velocity is predictive of the development of portal vein thrombosis : A matched case-control study. In: Liver International. 2018 ; Vol. 38, No. 1. pp. 94-101.
@article{0b8f3385b80449f3ad3d74380ad085e2,
title = "Decreased portal vein velocity is predictive of the development of portal vein thrombosis: A matched case-control study",
abstract = "Background & Aims: Portal vein thrombosis (PVT) in cirrhosis may lead to hepatic decompensation and increased mortality. We aimed to investigate if decreased portal vein (PV) velocity is associated with future PVT. Methods: Data on adult patients with cirrhosis and PVT between January 1, 2005 and July 30, 2015 were obtained. Cases with PVT were matched by age, gender and Model for End-stage Liver Disease (MELD) score to corresponding controls without PVT. Cox proportional hazards models, receiver operator curves and Kaplan Meier curves were constructed. Results: One hundred subjects (50 matched pairs) with mean age 53.8±13.1 y and MELD score 14.9±5.5 were included in our analysis. Sixty-four percent were male and 76{\%} were Child-Turcotte-Pugh Class A or B. Baseline characteristics (prior to development of PVT) were similar, except for baseline PV velocity (16.9 cm/s, 95{\%} CI 13.9-20.0 PVT vs 25.0, 95{\%} CI 21.8-28.8 no PVT, P<.001). 30 PVT subjects had PV velocity <15 cm/s compared to five without PVT (P<.001). On adjusted multivariable analysis, PV velocity was the strongest independent risk factor predicting PVT development (HR 0.86, 95{\%} CI 0.80-0.93). The predictive value for PVT development was greatest for flow <15 cm/s (c-statistic 0.77). PV velocity <15 cm/s had a highly significant association with future PVT (HR 6.00, 95{\%} CI 2.20-16.40, P=<.001). Conclusions: Decreased PV velocity is associated with increased risk of future PVT. Patients with cirrhosis and decreased PV velocity are a high-risk subgroup that warrants further investigation with prospective study.",
author = "Jonathan Stine and Jennifer Wang and Shah, {Puja M.} and Argo, {Curtis K.} and Nicolas Intagliata and Andre Uflacker and Caldwell, {Stephen H.} and Northup, {Patrick G.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/liv.13500",
language = "English (US)",
volume = "38",
pages = "94--101",
journal = "Liver International",
issn = "1478-3223",
publisher = "Wiley-Blackwell",
number = "1",

}

Stine, J, Wang, J, Shah, PM, Argo, CK, Intagliata, N, Uflacker, A, Caldwell, SH & Northup, PG 2018, 'Decreased portal vein velocity is predictive of the development of portal vein thrombosis: A matched case-control study', Liver International, vol. 38, no. 1, pp. 94-101. https://doi.org/10.1111/liv.13500

Decreased portal vein velocity is predictive of the development of portal vein thrombosis : A matched case-control study. / Stine, Jonathan; Wang, Jennifer; Shah, Puja M.; Argo, Curtis K.; Intagliata, Nicolas; Uflacker, Andre; Caldwell, Stephen H.; Northup, Patrick G.

In: Liver International, Vol. 38, No. 1, 01.01.2018, p. 94-101.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Decreased portal vein velocity is predictive of the development of portal vein thrombosis

T2 - A matched case-control study

AU - Stine, Jonathan

AU - Wang, Jennifer

AU - Shah, Puja M.

AU - Argo, Curtis K.

AU - Intagliata, Nicolas

AU - Uflacker, Andre

AU - Caldwell, Stephen H.

AU - Northup, Patrick G.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background & Aims: Portal vein thrombosis (PVT) in cirrhosis may lead to hepatic decompensation and increased mortality. We aimed to investigate if decreased portal vein (PV) velocity is associated with future PVT. Methods: Data on adult patients with cirrhosis and PVT between January 1, 2005 and July 30, 2015 were obtained. Cases with PVT were matched by age, gender and Model for End-stage Liver Disease (MELD) score to corresponding controls without PVT. Cox proportional hazards models, receiver operator curves and Kaplan Meier curves were constructed. Results: One hundred subjects (50 matched pairs) with mean age 53.8±13.1 y and MELD score 14.9±5.5 were included in our analysis. Sixty-four percent were male and 76% were Child-Turcotte-Pugh Class A or B. Baseline characteristics (prior to development of PVT) were similar, except for baseline PV velocity (16.9 cm/s, 95% CI 13.9-20.0 PVT vs 25.0, 95% CI 21.8-28.8 no PVT, P<.001). 30 PVT subjects had PV velocity <15 cm/s compared to five without PVT (P<.001). On adjusted multivariable analysis, PV velocity was the strongest independent risk factor predicting PVT development (HR 0.86, 95% CI 0.80-0.93). The predictive value for PVT development was greatest for flow <15 cm/s (c-statistic 0.77). PV velocity <15 cm/s had a highly significant association with future PVT (HR 6.00, 95% CI 2.20-16.40, P=<.001). Conclusions: Decreased PV velocity is associated with increased risk of future PVT. Patients with cirrhosis and decreased PV velocity are a high-risk subgroup that warrants further investigation with prospective study.

AB - Background & Aims: Portal vein thrombosis (PVT) in cirrhosis may lead to hepatic decompensation and increased mortality. We aimed to investigate if decreased portal vein (PV) velocity is associated with future PVT. Methods: Data on adult patients with cirrhosis and PVT between January 1, 2005 and July 30, 2015 were obtained. Cases with PVT were matched by age, gender and Model for End-stage Liver Disease (MELD) score to corresponding controls without PVT. Cox proportional hazards models, receiver operator curves and Kaplan Meier curves were constructed. Results: One hundred subjects (50 matched pairs) with mean age 53.8±13.1 y and MELD score 14.9±5.5 were included in our analysis. Sixty-four percent were male and 76% were Child-Turcotte-Pugh Class A or B. Baseline characteristics (prior to development of PVT) were similar, except for baseline PV velocity (16.9 cm/s, 95% CI 13.9-20.0 PVT vs 25.0, 95% CI 21.8-28.8 no PVT, P<.001). 30 PVT subjects had PV velocity <15 cm/s compared to five without PVT (P<.001). On adjusted multivariable analysis, PV velocity was the strongest independent risk factor predicting PVT development (HR 0.86, 95% CI 0.80-0.93). The predictive value for PVT development was greatest for flow <15 cm/s (c-statistic 0.77). PV velocity <15 cm/s had a highly significant association with future PVT (HR 6.00, 95% CI 2.20-16.40, P=<.001). Conclusions: Decreased PV velocity is associated with increased risk of future PVT. Patients with cirrhosis and decreased PV velocity are a high-risk subgroup that warrants further investigation with prospective study.

UR - http://www.scopus.com/inward/record.url?scp=85038866303&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85038866303&partnerID=8YFLogxK

U2 - 10.1111/liv.13500

DO - 10.1111/liv.13500

M3 - Article

C2 - 28632958

AN - SCOPUS:85038866303

VL - 38

SP - 94

EP - 101

JO - Liver International

JF - Liver International

SN - 1478-3223

IS - 1

ER -