Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany; General Internal Medicine and Thrombotic and Haemorrhagic Diseases Unit, Department of Medicine, University of Padua Medical School, Padua, Italy.
Epidemiological Department, Azienda Zero, Padova, Veneto Region, Italy.
Thromb Res. 2022 Jan;209:41-46. doi: 10.1016/j.thromres.2021.11.005. Epub 2021 Nov 22.
Splanchnic vein thrombosis (SVT) is an uncommon manifestation of venous thromboembolism. Epidemiological data on SVT-related mortality rate is not available to date.
We investigated time trends in SVT-related mortality rate, 2008-2019, in Veneto, an Italian high-income region of approximatively 5,000,000 inhabitants. SVT-related deaths were identified by the following ICD-10 codes: I81 (portal vein thrombosis), K75.1 (phlebitis of portal vein), K76.3 (liver infarction), K76.5 (hepatic veno-occlusive disease) or I82.0 (Budd-Chiari syndrome).
During the study period, a total of 557,932 deaths were recorded. SVT was reported in 823 cases; 776 (94%) consisted of portal vein thrombosis. The age-standardized SVT-related mortality rate varied from 1.47 (year 2008) to 1.52 (year 2019) per 100,000 person-years. An increase in the cause-specific annual mortality rate was observed in women (0.56 in 2008 to 1.04 per 100,000 person-years in 2019; average annual percent change +5.7%, 95%CI +3.1; +8.3%). In men, the cause-specific mortality rate moved from 2.53 in 2008 to 2.03 per 100,000 person-years in 2019 (average annual percent change -1.2%, 95%CI -4.0; +1.6%). After conditioning for age and sex, the odds of having a concomitant liver disease were higher for SVT-related deaths (OR 31.6; 95%CI 17.1-37.0) compared with non-SVT-related deaths. This also applies to gastrointestinal cancers (OR 1.28; 95%CI 1.07-1.55), although to a lesser extent.
We report first epidemiological estimates of SVT-related mortality in a Western country. These values will serve as a reference to weight novel potential factors associated with SVT-related death and interpret them from an epidemiological perspective.
内脏静脉血栓形成(SVT)是静脉血栓栓塞的一种罕见表现。目前尚无关于 SVT 相关死亡率的流行病学数据。
我们研究了 2008 年至 2019 年期间威尼托(意大利一个拥有约 500 万居民的高收入地区)SVT 相关死亡率的时间趋势。SVT 相关死亡通过以下 ICD-10 代码确定:I81(门静脉血栓形成)、K75.1(门静脉炎)、K76.3(肝梗死)、K76.5(肝静脉闭塞性疾病)或 I82.0(Budd-Chiari 综合征)。
在研究期间,共记录了 557932 例死亡。报告了 823 例 SVT 病例;776 例(94%)为门静脉血栓形成。标准化后的 SVT 相关死亡率从 2008 年的 1.47(每 100000 人年)到 2019 年的 1.52(每 100000 人年)。女性的特定原因年死亡率呈上升趋势(2008 年为 0.56,2019 年为每 100000 人年 1.04;平均年变化率+5.7%,95%CI+3.1%至+8.3%)。在男性中,特定原因死亡率从 2008 年的 2.53 降至 2019 年的 2.03 每 100000 人年(平均年变化率-1.2%,95%CI-4.0%至+1.6%)。在调整年龄和性别后,SVT 相关死亡的肝合并症的可能性高于非 SVT 相关死亡(比值比 31.6;95%CI 17.1-37.0)。这同样适用于胃肠道癌(比值比 1.28;95%CI 1.07-1.55),尽管程度较轻。
我们报告了西方国家 SVT 相关死亡率的首次流行病学估计。这些数值将作为参考,用于衡量与 SVT 相关死亡相关的新的潜在因素,并从流行病学角度对其进行解释。