Clinical Characteristics, Risk Factors, and Outcomes of Portal Vein Thrombosis in Non-cirrhotic Patients: A Retrospective Study

Non-cirrhotic portal vein thrombosis (PVT) is a rare but dangerous illness with few studies on risk factors and outcomes. This study sought to evaluate the clinical characteristics, risk factors, anticoagulation response, and consequences of non-cirrhotic PVT in hospitalized patients. We performed a retrospective study on 47 hospitalized patients with suspected non-cirrhotic PVT. Clinical, laboratory, and radiographic data were gathered. Descriptive statistics were employed to describe baseline attributes. The associations between risk factors and outcomes (thrombus resolution, intestinal ischemia, portal hypertension, and mortality) were examined using chi-square, Fisher's exact, Mann-Whitney U, and Kruskal-Wallis tests, if needed. Around 95.7% of patients (45/47) had radiologically verified non-cirrhotic PVT. The average age was 49.4 years (SD 19.5), and 61.7% were female. Obesity (BMI ≥30) was reported in 42.6%. Prothrombotic diseases were found in 17.0%, cancer in 25.5%, and a recent infection in 42.6%. Complete thrombus resolution occurred in 29.8% of cases, with no significant difference across anticoagulation methods (low molecular weight heparin (LMWH) 36.0%, direct oral anticoagulants (DOACs) 16.7%, and warfarin 50.0%; p=0.448). Bowel ischemia was substantially linked to recent infection (p = 0.016). The 90-day mortality rate was 17.0%. Significant univariate predictors of 90-day death were malignancy (p < 0.001), recent infection (p = 0.009), LMWH use (p = 0.018), and longer hospital stay (p = 0.041). There were no deaths among patients who received DOACs or warfarin. Non-cirrhotic PVT poses a significant mortality risk. Recent infection and underlying malignancy are strong indicators of negative outcomes. The link between anticoagulant type and mortality deserves additional exploration in prospective trials.