S2716 Cirrhosis Meets Clotting: A 6-Year Retrospective Study (2016-2021)

Introduction: Cirrhosis is a chronic liver condition associated with significant morbidity and mortality, often complicated by thrombotic events. Thrombosis in cirrhosis presents a significant challenge due to the coexistence of bleeding risks and hypercoagulability. This study examines the prevalence, demographic characteristics, trends, and clinical outcomes of thrombosis among patients with cirrhosis over a 6-year period. Methods: This retrospective cohort study analyzed patients admitted with cirrhosis and thrombosis. Data was acquired from the Nationwide Inpatient Sample from 2016 to 2021. Total hospital costs were calculated using HCUP Cost-to-Charge Ratio files and adjusted for inflation based on the Consumer Price Index (CPI) with 2021 as the reference year. Results: During the 6-year period 2016-2021, a total of 537,650 patients with cirrhosis were identified, of whom 89,220 were diagnosed with thrombosis (P = 0.04). Individuals with cirrhosis and thrombosis were older compared to those without thrombosis (mean age: 63 years vs 55 years, P < 0.001). There was a man predominance among patients with thrombosis (70% vs 30%). The White population had the highest prevalence, followed by Hispanics and Blacks (P = 0.8). Among thrombosis types, an increasing trend was observed in thrombophlebitis (P = 0.003), arterial embolism and thrombosis (P = 0.1), venous embolism and thrombosis which includes deep vein thrombosis (P < 0.001), atherosclerotic heart disease (P = 0.02), and portal vein thrombosis (P = 0.02). A steady trend was noted for pulmonary embolism (P < 0.001), while no significant changes were observed for septic arterial embolism (P = 0.3), athero-embolism (P = 0.9), or phlebitis (P = 0.2). Thrombosis was associated with an increased mortality rate (6% vs 5%, P < 0.001), longer hospital stays (mean: 7.2 vs 6 days), and higher hospital costs ($108,347 vs $79,230). Comorbidities were more common among patients with thrombosis and included coagulopathy (52%), anemia (39%), alcohol use (38%), hypertension (35%), heart failure (24%), obesity (17%), and diabetes (16%) (all P < 0.001). Conclusion: Thrombosis is a significant complication in patients with cirrhosis, particularly among older men and the White population. Its presence is associated with increased mortality, longer hospital stays, and higher healthcare costs. Trends indicate rising rates of venous thrombosis, portal vein thrombosis, and other thrombotic conditions, with notable comorbidities contributing to the disease burden.