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Pharmacological Prophylaxis Doesn’t Cut VTE in Cirrhosis

Low rate of VTE in hospitalized patients with cirrhosis; unaffected by pharmacological prophylaxis

THURSDAY, July 23, 2015 (HealthDay News) — Pharmacological thromboprophylaxis does not reduce the risk of venous thromboembolism (VTE) in patients with cirrhosis, according to a study published in the July issue of the Journal of Thrombosis and Haemostasis.

Joseph J. Shatzel, M.D., from the Dartmouth Hitchcock Medical Center in Lebanon, N.H., and colleagues examined the safety and efficacy of pharmacological VTE prophylaxis in hospitalized patients with cirrhosis in a retrospective cohort study. Data were included for 402 patients with cirrhosis, with 600 hospitalizations over a five-year period.

The researchers found that in 49 percent of admissions, VTE prophylaxis was administered. Patients receiving VTE prophylaxis were older, had longer lengths of stay, and lower Model for End-Stage Liver Disease scores. Between the groups, in-hospital bleeding events, gastrointestinal bleeding events, new VTE events, and mortality were similar. The risk of VTE was not reduced with VTE prophylaxis (odds ratio, 0.94; 95 percent confidence interval, 0.23 to 3.71). Increased risk for in-hospital bleeding events was seen for patients receiving unfractionated heparin (odds ratio, 2.38; 95 percent confidence interval, 1.15 to 4.94), but not low-molecular-weight heparin (odds ratio, 0.87; 95 percent confidence interval, 0.37 to 2.05).

“The rate of VTE in this cohort of hospitalized cirrhotic patients was low and was unaffected by pharmacological thromboprophylaxis,” the authors write.

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