The PH score: a practical tool for screening myeloproliferative neoplasms in acute portal vein thrombosis

Portal vein thrombosis (PVT) is a rare but clinically significant condition often associated with myeloproliferative neoplasms (MPNs). Diagnosing MPNs in acute PVT may be difficult, particularly in the absence of overt hematologic abnormalities. We retrospectively analyzed 93 patients with acute PVT from January 2009 to June 2024, excluding those with chronic thrombosis or previously established systemic diseases. MPNs were identified in 23 patients (24.7%). Hemoglobin (Hb), platelet count (Plt) and inflammatory indices (PLR, SII, and PIV) were associated with MPNs in univariate analyses (p < 0.05), while Hb and Plt were retained as independent predictors in a parsimonious multivariable logistic regression model. Based on these parameters, the PH score was developed: PH = (0.510 × Hb) + (0.006 × Plt) - 9.470. The model demonstrated acceptable discriminative performance, with an apparent AUC of 0.864 in the training cohort and an AUC of 0.820 on internal validation in the overall cohort, using an optimal cut-off value of - 1.016. The PH score may act as a straightforward laboratory tool to aid in early risk stratification for patients with acute PVT, complementing, but not replacing, the standard diagnostic evaluation.