DIVI 2019 Abstractbuch

DIVI 2019 04. – 06.12.2019 | Hamburg Messe 100 EP/07/04 Anticoagulation and portal vein thrombosis in critically ill patients with liver cirrhosis - a prelimi- nary analysis A. Drolz 1 , K. Roedl 1 , T. Horvatits 1 , K. Horvatits 1 , D. Reher 1 , S. Kluge 1 , V. Fuhrmann 1 1 Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland Introduction: Portal vein thrombosis is a life-threatening complication in patients with liver cirrhosis. Because of the susceptibility for both bleedings and thromboembolic complications, anticoagulation, especially at the ICU, is a controversial topic in cirrhosis patients. Aim of this study was to assess the incidence of portal vein thrombosis in critically ill cirrhosis patients with respect to use of anticoagula- tion. Methods: Critically ill patients with cirrhosis were identified at the University Medical Center Ham- burg Eppendorf between 2009 and 2014. Patients with uncontrolled bleedings on ICU admission were excluded from analysis. Presence/development of portal vein thrombosis was assessed via sonography or CT-scans. Use of anticoagulation was documented and outcome data were assessed in all patients. Results: Three hundred eighty-eight ICU patients with cirrhosis were included in the analysis. Medi- an age was 59 (IQR 51-66) years, 39% (n=152) were females. Median CLIF-SOFA score on admissi- on was 11 (IQR 7-14). 28-day mortality was 36% (n=139) and 90-day mortality 46% (n=180). New portal vein thrombosis (occurring during ICU stay) was found in 14 patients (4%). Two hundred sixty-eight patient received anticoagulation during the ICU stay (64 high-dose/therapeutic and 204 low-dose/prophylactic). Incidence of new portal vein thrombosis was 3.3% (n=4) in patients without and 3.7% (n=10) in patients with anticoagulation (p=0.846). Even after adjustment for age, sex and CLIF-SOFA score, anticoagulation at the ICU showed no impact on incidence of portal vein thrombo- sis during the ICU stay (OR 0.97 (95% CI 0.29-3.22), p=0.954). Conclusion: Portal vein thrombosis occurred in 4% of critically ill cirrhosis patients. We did not ob- serve significant differences in the incidence of portal vein thrombosis between patients with and without anticoagulation. Further studies are required to assess risks and potential benefits of anticoa- gulation in cirrhosis at the ICU.