Risk of venous thromboembolism in patients with liver disease: A nationwide population-based case-control study

Kirstine Kobberøe Søgaard, Erzsébet Horváth-Puhó, Henning Grønbæk, Peter Jepsen, Hendrik Vilstrup, Henrik Toft Sørensen

Research output: Contribution to journalArticle

254 Citations (Scopus)

Abstract

OBJECTIVES: It is known that liver disease can cause an imbalance in the coagulation system, but available data on liver disease and risk of venous thromboembolism are conflicting. We examined the risk of venous thromboembolism in patients hospitalized with liver diseases. METHODS: We conducted a nationwide Danish case-control study of incident cases of venous thromboembolism from 1980 to 2005 using population-based data from the National Registry of Patients, and from the Civil Registration System. We used conditional logistic regression to compute the relative risk of venous thromboembolism in patients with liver disease compared to population controls. We then excluded patients with known malignancy (diagnosed either before or up to 3 months after the venous thromboembolism) or fractures, trauma, surgery, or pregnancy within 90 days before the venous thromboembolism to estimate the risk associated with unprovoked venous thromboembolism. RESULTS: A total of 99,444 patients with venous thromboembolism and 496,872 population controls were included in the study. Patients with liver disease had a clearly increased relative risk of venous thromboembolism, varying from 1.74 (95 CI, 1.54-1.95) for liver cirrhosis to 1.87 (95 CI, 1.73-2.03) for non-cirrhotic liver disease. The risks were higher for deep venous thrombosis compared with pulmonary embolism. In the analysis, restricted to 67,519 patients with unprovoked venous thromboembolism and 308,614 population controls, we found slightly higher relative risks: 2.06 (95 CI, 1.79-2.38) for liver cirrhosis and 2.10 (95 CI, 1.91-2.31) for non-cirrhotic liver disease. CONCLUSIONS: Patients with liver disease have a substantially increased risk of venous thromboembolism.

Original languageEnglish
Pages (from-to)96-101
Number of pages6
JournalAmerican Journal of Gastroenterology
Volume104
Issue number1
DOIs
Publication statusPublished - Jan 2009

Fingerprint

Venous Thromboembolism
Case-Control Studies
Liver Diseases
Population
Population Control
Liver Cirrhosis
Pulmonary Embolism
Information Systems
Venous Thrombosis
Registries
Logistic Models
Pregnancy

ASJC Scopus subject areas

  • Gastroenterology
  • Medicine(all)

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Risk of venous thromboembolism in patients with liver disease : A nationwide population-based case-control study. / Søgaard, Kirstine Kobberøe; Horváth-Puhó, Erzsébet; Grønbæk, Henning; Jepsen, Peter; Vilstrup, Hendrik; Sørensen, Henrik Toft.

In: American Journal of Gastroenterology, Vol. 104, No. 1, 01.2009, p. 96-101.

Research output: Contribution to journalArticle

Søgaard, Kirstine Kobberøe ; Horváth-Puhó, Erzsébet ; Grønbæk, Henning ; Jepsen, Peter ; Vilstrup, Hendrik ; Sørensen, Henrik Toft. / Risk of venous thromboembolism in patients with liver disease : A nationwide population-based case-control study. In: American Journal of Gastroenterology. 2009 ; Vol. 104, No. 1. pp. 96-101.
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AB - OBJECTIVES: It is known that liver disease can cause an imbalance in the coagulation system, but available data on liver disease and risk of venous thromboembolism are conflicting. We examined the risk of venous thromboembolism in patients hospitalized with liver diseases. METHODS: We conducted a nationwide Danish case-control study of incident cases of venous thromboembolism from 1980 to 2005 using population-based data from the National Registry of Patients, and from the Civil Registration System. We used conditional logistic regression to compute the relative risk of venous thromboembolism in patients with liver disease compared to population controls. We then excluded patients with known malignancy (diagnosed either before or up to 3 months after the venous thromboembolism) or fractures, trauma, surgery, or pregnancy within 90 days before the venous thromboembolism to estimate the risk associated with unprovoked venous thromboembolism. RESULTS: A total of 99,444 patients with venous thromboembolism and 496,872 population controls were included in the study. Patients with liver disease had a clearly increased relative risk of venous thromboembolism, varying from 1.74 (95 CI, 1.54-1.95) for liver cirrhosis to 1.87 (95 CI, 1.73-2.03) for non-cirrhotic liver disease. The risks were higher for deep venous thrombosis compared with pulmonary embolism. In the analysis, restricted to 67,519 patients with unprovoked venous thromboembolism and 308,614 population controls, we found slightly higher relative risks: 2.06 (95 CI, 1.79-2.38) for liver cirrhosis and 2.10 (95 CI, 1.91-2.31) for non-cirrhotic liver disease. CONCLUSIONS: Patients with liver disease have a substantially increased risk of venous thromboembolism.

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