Analysis of related factors of hemorrhage after anticoagulant therapy for femoral vein catheter-related thrombosis in patients with end-stage liver disease

Abstract

Abstract: Objective To investigate the efficacy of anticoagulant therapy for femoral vein catheter-related thrombosis in patients with end-stage liver disease (ESLD) and the risk factors of bleeding after treatment. To provide effective scientific basis for anticoagulant therapy for deep venous thrombosis in patients with ESLD. Methods The data of 62 inpatients with ESLD and femoral vein catheter-related thrombosis in our hospital from January 2019 to May 2021 were collected. Clinical general data and laboratory indexes of patients with bleeding and non-bleeding after anticoagulation therapy were analyzed retrospectively; investigating factors associated with the time from anticoagulation to thrombus disappearance. Results A total of 62 patients were enrolled, including 15 cases (24.2%) in bleeding group and 47 cases (75.8%) in non-bleeding group. There were significant differences in total anticoagulation time 8.0 (4.0,22.0) vs 21.0 (9.0,42.0) days and FT4 14.6 (13.4,17.3) vs 18.0 (14.7,21.4) pmol/L between bleeding group and non-bleeding group (P＜0.05). The result of multiple linear regression showed that the time from anticoagulation to thrombus disappearance was significantly correlated to creatinine (Cr) and anticoagulant drugs (low molecular weight heparin, rivaroxaban, low molecular weight heparin + rivaroxaban or other drugs), (P＜0.05). Conclusion There is no significant difference between the choice of anticoagulant drugs (low molecular weight heparin, rivaroxaban or low molecular weight heparin + rivaroxaban) and curative effect in the treatment of bleeding complications in ESLD patients with catheter-related deep vein thrombosis. FT4 may be correlated with anticoagulant bleeding, while Cr is negatively correlated with the time from anticoagulant to thrombus disappearance. Before anticoagulation, it is necessary to pay attention to Objective indexes such as FT4 and Cr, which can predict the time of anticoagulation bleeding and thrombus disappearance.

Key words: End-stage liver disease, Anticoagulation, Bleeding, Related factors

PENG Jing-han, HUANG De-liang, YU Hong, CHEN Jun. Analysis of related factors of hemorrhage after anticoagulant therapy for femoral vein catheter-related thrombosis in patients with end-stage liver disease[J]. Chinese Hepatolgy, 2023, 28(2): 165-170.

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