Department of Internal Medicine, University of California, San Francisco, Fresno, California, USA.
Liver Institute Northwest, Seattle, WA, USA.
Pancreatology. 2023 Jun;23(4):350-357. doi: 10.1016/j.pan.2023.03.008. Epub 2023 Mar 29.
BACKGROUND/OBJECTIVE: Portal vein thrombosis (PVT) is a well-known complication in patients with acute pancreatitis (AP). Limited data exist on the incidence and factors of PVT in patients with AP. We investigate the incidence and clinical predictors of PVT in AP.
We queried the 2016-2019 National Inpatient Sample database to identify patients with AP. Patients with chronic pancreatitis or pancreatic cancer were excluded. We studied demographics, comorbidities, complications, and interventions in these patients and stratified the results by the presence of PVT. A multivariate regression model was used to identify factors associated with PVT in patients with AP. We also assessed the mortality and resource utilization in patients with PVT and AP.
Of the 1,386,389 adult patients admitted with AP, 11,135 (0.8%) patients had PVT. Women had a 15% lower risk of developing PVT (aOR-0.85, p < 0.001). There was no significant difference between the age groups in the risk of developing PVT. Hispanic patients had the lowest risk of PVT (aOR-0.74, p < 0.001). PVT was associated with pancreatic pseudocyst (aOR-4.15, p < 0.001), bacteremia (aOR-2.66, p < 0.001), sepsis (aOR-1.55, p < 0.001), shock (aOR-1.68, p < 0.001) and ileus (aOR-1.38, p < 0.001). A higher incidence of in-hospital mortality and ICU admissions was also noted in patients with PVT and AP.
This study demonstrated a significant association between PVT and factors such as pancreatic pseudocyst, bacteremia, and ileus in patients with AP.
背景/目的：门静脉血栓形成（PVT）是急性胰腺炎（AP）患者的一种众所周知的并发症。目前关于 AP 患者 PVT 的发生率和相关因素的数据有限。我们旨在调查 AP 患者中 PVT 的发生率及其临床预测因素。
我们从 2016 年至 2019 年国家住院患者样本数据库中查询了 AP 患者的信息。排除了患有慢性胰腺炎或胰腺癌的患者。我们研究了这些患者的人口统计学特征、合并症、并发症和干预措施，并根据 PVT 的存在对结果进行了分层。使用多变量回归模型来确定 AP 患者发生 PVT 的相关因素。我们还评估了伴有 PVT 的 AP 患者的死亡率和资源利用情况。
在 1386389 例成年 AP 住院患者中，有 11135 例（0.8%）患者发生了 PVT。女性发生 PVT 的风险降低 15%（调整后比值比[aOR]为 0.85，p<0.001）。不同年龄组发生 PVT 的风险无显著差异。西班牙裔患者发生 PVT 的风险最低（aOR 为 0.74，p<0.001）。PVT 与胰腺假性囊肿（aOR 为 4.15，p<0.001）、菌血症（aOR 为 2.66，p<0.001）、败血症（aOR 为 1.55，p<0.001）、休克（aOR 为 1.68，p<0.001）和肠梗阻（aOR 为 1.38，p<0.001）有关。伴有 PVT 的 AP 患者的住院死亡率和 ICU 入院率也较高。
本研究表明，PVT 与 AP 患者的胰腺假性囊肿、菌血症和肠梗阻等因素之间存在显著相关性。
