From the Division of Gastroenterology, University of Tennessee Health Science Center, Memphis, TN.
Division of Gastroenterology and Liver Disease, University Hospitals Cleveland Medical Center, Cleveland, OH.
Pancreas. 2021 Jan 1;50(1):71-76. doi: 10.1097/MPA.0000000000001714.
Studies on the incidence of venous thromboembolism (VTE) in acute pancreatitis (AP) are scarce. We conducted a large database study to evaluate this relationship.
Data were extracted from a large electronic health record (Explorys; IBM Watson Health, Armonk, NY). We identified patients with AP in 2018 and 2019, analyzing VTE incidence at 30 days after diagnosis of AP. Univariate and multivariate analyses were performed to identify risk factors associated with VTE.
A total of 25,620 cases of acute necrotizing pancreatitis (ANP) and 155,800 cases of acute nonnecrotizing pancreatitis (ANNP) were identified. The incidence of VTE was 7.1% for ANP, compared with 2.8% in ANNP (P < 0.001). On multivariate analysis, ANP conferred significantly greater odds of VTE (adjusted odds ratio, 2.78; 95% confidence interval, 2.73-2.84; P < 0.001), independent of other variables. In those with ANP, the presence of VTE was associated with a significantly higher mortality (23.5% vs 15.9%, P < 0.001).
Acute necrotizing pancreatitis carries near 2.5-fold risk of VTE, and a 3-fold risk of PE, compared with those with ANNP. Venous thromboembolism development in ANP is associated with higher mortality.
关于急性胰腺炎（AP）患者静脉血栓栓塞症（VTE）发生率的研究较少。我们进行了一项大型数据库研究来评估这种关系。
从一个大型电子健康记录（Explorys；IBM Watson Health，Armonk，NY）中提取数据。我们在 2018 年和 2019 年确定了 AP 患者，并在诊断 AP 后 30 天分析 VTE 的发生率。进行单变量和多变量分析以确定与 VTE 相关的危险因素。
共确定了 25620 例急性坏死性胰腺炎（ANP）和 155800 例急性非坏死性胰腺炎（ANNP）病例。ANP 的 VTE 发生率为 7.1%，而 ANNP 为 2.8%（P < 0.001）。多变量分析显示，ANP 显著增加 VTE 的发生几率（调整后的优势比，2.78；95%置信区间，2.73-2.84；P < 0.001），独立于其他变量。在患有 ANP 的患者中，VTE 的存在与显著更高的死亡率相关（23.5%比 15.9%，P < 0.001）。
与患有 ANNP 的患者相比，急性坏死性胰腺炎发生 VTE 的风险高近 2.5 倍，发生 PE 的风险高 3 倍。在 ANP 中发生静脉血栓栓塞症与更高的死亡率相关。
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