Efficacy and Safety of Anticoagulants in Patients With Cirrhosis and Portal Vein Thrombosis: A Systematic Review and Meta‐Analysis of Randomized and Non‐Randomized Studies
Bibliographic record
Abstract
ABSTRACT Background Portal vein thrombosis (PVT) contributes substantially to morbidity and mortality in cirrhotic patients. A clear insight into the anticoagulation therapy benefits in these patients could improve clinical decision‐making. This meta‐analysis aimed to assess the efficacy and safety of Anticoagulants in cirrhotic patients with PVT. Methods PubMed, Cochrane Library, and ScienceDirect were searched from inception to September 2024. The Risk Ratios (RR) with 95% Confidence Interval (CI) were pooled for dichotomous outcomes under the random effects model using Review Manager 5.4.1. The primary endpoint of interest is PVT recanalization. Quality assessment was done through the Newcastle Ottawa Scale and the Cochrane RoB2.0 tool. Leave‐one‐out sensitivity analysis was done to investigate the cause of heterogeneity. Publication bias was assessed through funnel plots. Results Twenty‐three studies (including 19 cohorts and 4 Randomized trials), pooling 81,599 patients, were included in the analysis. Anticoagulants significantly increased the PVT recanalization (RR = 2.00; 95% CI: [1.59, 2.52]; p < 0.00001; I 2 = 13%), PVT improvement (RR = 1.98; 95% CI: [1.70, 2.29], p < 0.00001; I 2 = 0%) while decreasing the PVT stability (RR = 0.78; 95% CI: [0.62,0.99], p = 0.04; I 2 = 19%) and PVT progression (RR = 0.42; 95% CI: [0.29, 0.60], p < 0.00001; I 2 = 27%). Other outcomes including mortality (RR = 0.53; 95% CI: [0.27, 1.03]; p = 0.06; I 2 = 94%), total bleeding (RR = 1.02; 95% CI: [0.76, 1.37], p = 0.89; I 2 = 31%), esophageal variceal bleeding (RR = 0.74; 95% CI: [0.54, 1.01], p = 0.06; I 2 = 56%), Gastrointestinal bleeding (RR = 1.07; 95% CI: [0.78, 1.48]; p = 0.66, I 2 = 13%) and Intracranial hemorrhage (RR = 1.19; 95% CI: [0.89, 1.58], p = 0.24, I 2 = 0%) were comparable between the 2 arms. Conclusion Anticoagulants significantly increased PVT recanalization and PVT improvement while decreasing PVT stability and PVT progression in cirrhotic patients. Other outcomes were comparable between the two groups.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.037 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.021 | 0.037 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".