Predictive Value of Inflammation Biomarkers in Patients with Portal Vein Thrombosis

Abstract

Background and Aims:To investigate the usefulness of inflammation biomarkers to serve as a predictors of portal vein thrombosis (PVT) postoperatively (post) in patients with portal hypertension after splenectomy and periesophagogastric devascularization. Methods: A total of 177 liver cirrhosis patients were recruited from January 2013 to December 2017. They were divided into a PVT group (n=71) and a non-PVT group (n=106), according to ultrasound examination findings at 7-day post. Inflammation biomarkers involving platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), red blood cell distribution width-to-platelet ratio(RPR), mean platelet volume-to-platelet ratio (MPR) preoperatively (pre) and at 1, 3, 7-days post were recorded. Results: The univariate logistic regression analysis indicated that PLR (pre) (odds ratio (OR)=3.963, 95% confidence interval (CI)=2.070-7.587, p<0.000), MLR (pre) (OR=2.760, 95% CI=1.386-5.497, p=0.004), PLR (postday 7) (OR=3.345, 95% CI=1.767-6.332, p=0.000) were significantly associated with the presence of PVT. The multivariate logistic regression analysis results indicated that PLR (pre) (OR=3.037, 95% CI=1.463-6.305, p=0.003), MLR (pre) (OR=2.188, 95% CI=1.003-4.772, p=0.049), PLR(post-day 7) (OR=2.166, 95% CI=1.053-4.454, p=0.036) were independent factors for predicting PVT. Conclusions: The PLR (pre), MLR (pre), and PLR (post-day 7) are predictors of portal vein thrombosis post in patients with portal hypertension after splenectomy and periesophagogastric devascularization.

Assessment of portal system hemodynamics for the prediction of portal vein thrombosis in cirrhosis—A systematic review and meta‐analysis

“…Figure 1 shows the flowchart for the study selection and inclusion process. Among these 31 studies, 19 included patients with cirrhosis, 12–30 and 12 included patients with cirrhosis who had undergone splenectomy 31–42 . Table 1 shows the baseline characteristics of the included studies.…”

“…The median follow‐up duration varied from 1 to 11 years. For studies in patients with cirrhosis undergoing splenectomy, all the studies were from China 31–42 . Based on the study design, 3 were case–control, 31,35,39 while 9 were cohort studies 32–34,36–38,40–42 .…”

“…For studies in patients with cirrhosis undergoing splenectomy, all the studies were from China. [31][32][33][34][35][36][37][38][39][40][41][42] Based on the study design, 3 were case-control, 31,35,39 while 9 were cohort studies. [32][33][34][36][37][38][40][41][42] The median follow-up duration varied from 1 to 42.7 months.…”

“…The length of the spleen between patients with or without PVT was compared by five studies in patients with cirrhosis 18,20,22,23,30 and seven studies [33][34][35]37,[39][40][41] in patients with cirrhosis undergoing splenectomy ± devascularization (Figure S1). The splenic length was significantly shorter in patients not developing PVT compared to those developing PVT, both in patients with cirrhosis and those with cirrhosis undergoing splenectomy ± devascularization, with MD of À1.17 cm (95% CI: À1.59 to À0.75; I 2 = 60%) and À0.98 cm (95% CI:…”

“…Tables S1 and S2 summarize the study quality analysis for cohort and case-control studies. Among cohort studies, 3 were of poor quality, 13,37,42 3 were of fair quality, 15,34,36 and the rest were of good quality. Among case-control studies, 2 were of poor quality, 22,31 2 were of fair quality, 28,35 and the rest were of good quality.…”