Retrospective Cohort Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2021; 9(31): 9406-9416
Published online Nov 6, 2021. doi: 10.12998/wjcc.v9.i31.9406
Establishment of a risk assessment score for deep vein thrombosis after artificial liver support system treatment
You-Wen Tan, Cong Yang, Li Zhu, Xiang Li, Yun Ye
Yun Ye, Xiang Li, Li Zhu, Cong Yang, You-Wen Tan, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212000, Jiangsu Province, China
Author contributions: Ye Y and Li X contributed equally to this manuscript; Tan YW and Ye Y designed the research; Zhu L and Yang C collected and analyzed the data, and drafted the manuscript; Tan YW, Ye Y and Li X wrote and revised the manuscript; all authors have read and approved the final version to be published.
Supported by China Public Health Alliance, No. GWLM202031.
Institutional review board statement: This study was approved by The Third Hospital of Zhenjiang Affiliated Jiangsu University.
Informed consent statement: Informed consent for this study was not required as the clinical data were anonymous.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: You-Wen Tan, MD, Chief Doctor, Professor, Department of Hepatology, The Third Hospital of Zhenjiang Affiliated Jiangsu University, No. 300 Danjiamen, Runzhou District, Zhenjiang 212000, Jiangsu Province, China. tyw915@sina.com
Received: May 18, 2021
Peer-review started: May 18, 2021
First decision: June 12, 2021
Revised: June 13, 2021
Accepted: September 23, 2021
Article in press: September 23, 2021
Published online: November 6, 2021
Processing time: 164 Days and 9.1 Hours
Abstract
BACKGROUND

The artificial liver support system (ALSS) is an effective treatment method for liver failure, but it requires deep venous intubation and long-term indwelling catheterization. However, the coagulation mechanism disorder of basic liver failure diseases, and deep venous thrombosis (DVT) often occur.

AIM

To evaluate the risk factors for DVT following use of an ALSS and establish a risk assessment score.

METHODS

This study was divided into three stages. In the first stage, the risk factors for DVT were screened and the patient data were collected, including ALSS treatment information; biochemical indices; coagulation and hematology indices; complications; procoagulant use therapy status; and a total of 24 indicators. In the second stage, a risk assessment score for DVT after ALSS treatment was developed. In the third stage, the DVT risk assessment score was validated.

RESULTS

A total of 232 patients with liver failure treated with ALSS were enrolled in the first stage, including 12 with lower limb DVT. Logistic regression analysis showed that age [odds ratio (OR), 1.734; P = 0.01], successful catheterization time (OR, 1.667; P = 0.005), activity status (strict bed rest) (OR, 3.049; P = 0.005), and D-dimer level (≥ 500 ng/mL) (OR, 5.532; P < 0.001) were independent risk factors for DVT. We then established a scoring system for risk factors. In the validation group, a total of 213 patients with liver failure were treated with ALSS, including 14 with lower limb DVT. When the cutoff value of risk assessment was 3, the specificity and sensitivity of the risk assessment score were 88.9% and 85.7%, respectively.

CONCLUSION

A simple risk assessment scoring system was established for DVT patients with liver failure treated with ALSS and was verified to have good sensitivity and specificity.

Keywords: Artificial liver support system; Deep vein thrombosis; Liver failure; Risk factors; Thrombosis

Core Tip: The risk factors for deep vein thrombosis (DVT) after the use of an artificial liver support system (ALSS) and a risk assessment score were established. A total of 232 patients with liver failure treated with ALSS were enrolled in the first stage, including 12 with lower limb DVT. Logistic regression analysis showed that age, successful catheterization time, activity status (strict bed rest), and D-dimer level (≥ 500 ng/mL) were independent risk factors for DVT. In the risk assessment scoring system validation group, when the cutoff value of risk assessment was 3, the specificity and sensitivity of the risk assessment score were 88.9% and 85.7%, respectively.