Risk factors for portal vein thrombosis after splenectomy for portal hypertension due to liver cirrhosis and establishment of its prediction model
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R654.3

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    Abstract:

    Objective: To analyzed the risk factors for the formation of portal vein thrombosis (PVT) after splenectomy for portal hypertension due to liver cirrhosis, and to establish a Logistic regression model for predicting the occurrence of PVT. Methods: The relevant perioperative factors in 236 eligible patients undergoing splenectomy were determined by univariate analysis and multiple Logistic regression analysis, respectively, and Logistic regression prediction model was established based on the results of the multivariate analysis. Subsequently, Logit P was calculated and the ROC curve of each independent factor for estimating PVT was drawn. Results: Logistic regression analysis showed that preoperative velocity of portal venous blood flow (VPBF), postoperative mean platelet volume (MPV), postoperative D-dimer (D-D), and intraoperative free portal venous pressure difference (FPPD) were the independent risk factors while postoperative usage of anticoagulation therapy (UAT) was an independent protective factor for postoperative PVT (all P<0.05). According to the above factors, Logistic regression prediction model was established and expressed as Logit P=–5.715–0.558×VPBF (cm/s)+ 0.592×MPV (fL)+0.707×D-D (mg/L)+0.573×FPPD (cmH2O)–0.872×UAT (yes=1, no=0), and the cut off value of Logit P was -0.96, the area under ROC (AUROC) and the accuracy were 0.898 and 86.9%, and the cut off value for VPBF, MPV, D-D and FPPD was 13.85 cm/s, 10.92 fL, 3.54 mg/L and 6.99 cmH2O, respectively. Conclusion: Factors that include VPBF≤13.85 cm/s, MPV≥10.92fL, D-D≥3.54 mg/L and FPPD≥6.99 cmH2O may increase the risk of postoperative PVT, while postoperative UAT may decreased the risk of postoperative PVT; the established prediction model has relatively high accuracy for predicting PVT in those patients, and has certain reference value in clinical practice.

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HE Shasha, FAN Xiaotang, SHI Xiujiang, FENG Juan, A Liya, HE Fangping. Risk factors for portal vein thrombosis after splenectomy for portal hypertension due to liver cirrhosis and establishment of its prediction model[J]. Chin J Gen Surg,2016,25(12):1766-1772.
DOI:10.3978/j. issn.1005-6947.2016.12.016

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History
  • Received:June 16,2016
  • Revised:August 09,2016
  • Adopted:
  • Online: December 15,2016
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