C0014 - Incidence and Clinical Predictors of Portal Vein Thrombosis (PVT) in Acute Pancreatitis: A Nationwide Analysis

Hunza Chaudhry, MD¹, Aalam Sohal, MD², Armaan Dhaliwal, MBBS³, Kanwal Bains, MBBS⁴, Gagan Gupta, MBBS⁵, Piyush Singla, MBBS⁶, Raghav Sharma, MBBS⁷, Sohail Sodhi, MD⁸, Dino Dukovic, ⁹, Jayakrishna Chintanaboina, MD^1
1UCSF-Fresno, Fresno, CA; ²UCSF Fresno, Fresno, CA; ³University of Arizona, Tucson, AZ; ⁴Brigham and Women’s Hospital, Boston, MA; ⁵Dayanand Medical College and Hospital, Phillaur, Punjab, India; ⁶Dayanand Medical College and Hospital, Ludhiana, Punjab, India; ⁷Punjab Instute of Medical Sciences, Jalandhar, Jalandhar, Punjab, India; ⁸Rutgers Health/Trinitas Regional Medical Center, Elizabeth, NJ; ⁹Ross University School of Medicine, Anaheim, CA

Introduction: Portal vein thrombosis (PVT) is a well-known complication in patients with acute pancreatitis (AP). Limited data exist on the incidence and factors associated with PVT in patients with AP. We investigate the incidence and clinical predictors of PVT in hospitalized patients with AP between 2016-2019.

Methods: We queried the 2016-2019 National Inpatient Sample (NIS) database using ICD-10 codes. All adult patients with a diagnosis of AP (ICD10 K85) were included, while patients with chronic pancreatitis were excluded from the analysis. We studied demographics, comorbidities, complications, and interventions in patients with acute pancreatitis and stratified the results by the presence of PVT. Multivariate analysis was conducted to elucidate factors associated with PVT in patients with AP. We adjusted for patient demographics, hospital characteristics, elixhauser comorbidities, and common complications of pancreatitis. We also studied the effect of PVT on length of stay, total hospitalization charge and mortality.

Results: Of the 1,386,389 adult patients admitted with AP, 11,135 (0.8%) patients had PVT. A complete list of patient characteristics is presented in Table 1. Female gender was associated with a 15.3% lower risk of developing PVT (aOR-0.847, p-< 0.001). There was no significant difference between the age groups (18-44, 45-64, and >65 years) on the risk of developing PVT. Hispanic patients had the lowest risk of PVT (aOR-0.74, p< 0.001) while White patients had the highest risk. 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-1.69, p < 0.001) and ileus (aOR-1.38, p< 0.001). The presence of PVT was associated with a higher risk of mortality (aOR-1.35, 95% CI-1.09-1.66, p< 0.001), length of stay (+4.02 days, p< 0.001), and total hospitalization charge ($43,592.1, p< 0.001) as compared to patients without PVT.

Discussion: Our retrospective analysis demonstrated that a significant association exists between portal vein thrombosis and factors such as pancreatic pseudocyst, bacteremia, and ileus in patients with AP. Thrombotic events are a known complication of AP and should be evaluated and managed diligently. Physicians should be aware of the factors associated with portal vein thrombosis as the presence of PVT portends to poor prognosis.



Disclosures:


Hunza Chaudhry, MD¹, Aalam Sohal, MD², Armaan Dhaliwal, MBBS³, Kanwal Bains, MBBS⁴, Gagan Gupta, MBBS⁵, Piyush Singla, MBBS⁶, Raghav Sharma, MBBS⁷, Sohail Sodhi, MD⁸, Dino Dukovic, ⁹, Jayakrishna Chintanaboina, MD¹. C0014 - Incidence and Clinical Predictors of Portal Vein Thrombosis (PVT) in Acute Pancreatitis: A Nationwide Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.