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Thromboembolic Complications in the First Year After Acute Pancreatitis Diagnosis
Alexandria J Robbins1, Elizabeth Lusczek1, Melena D Bellin
1From the Departments of Surgery.
Insights
Hospitalized patients with pancreatitis face a significant risk of venous thromboembolic (VTE) events, including pulmonary embolism and deep vein thrombosis, within a year of diagnosis. These events are linked to increased mortality and poorer patient outcomes.
Area of Science:
- Gastroenterology
- Hematology
- Clinical Medicine
Background:
- Venous thromboembolic (VTE) events pose a significant risk to hospitalized patients.
- Pancreatitis is a complex condition with potential systemic complications.
- Understanding VTE prevalence in pancreatitis is crucial for patient management.
Purpose of the Study:
- To quantify the incidence of VTE in patients hospitalized with pancreatitis.
- To assess the impact of VTE on patient outcomes, including mortality and readmissions.
- To identify risk factors associated with VTE development in this population.
Main Methods:
- Retrospective cohort study of adult patients hospitalized for pancreatitis between 2011 and 2018.
- Evaluation of VTE events (pulmonary embolism, deep vein thrombosis, mesenteric vessel thrombosis) within 30 days of discharge in the first year post-diagnosis.
- Comparison of characteristics and outcomes between patients with and without VTE.
Main Results:
- A total of 4613 patients were identified, with 301 (6.5%) experiencing a VTE event.
- VTE patients were more likely to be male, older, and have a pre-existing coagulopathy.
- VTE was associated with significantly higher mortality (27% vs 13%), increased readmissions, longer hospital stays, and non-home discharge.
Conclusions:
- Hospitalized acute pancreatitis significantly increases the risk of VTE within the first year post-diagnosis.
- Thromboembolic disease in pancreatitis patients correlates with adverse morbidity and mortality.
- Early identification and management of VTE risk factors are essential for improving outcomes in pancreatitis patients.
Objectives:
This study aimed to quantify the prevalence of venous thromboembolic (VTE) events in patients with pancreatitis requiring hospitalization and its impact on outcomes.
Methods:
Adult patients admitted from 2011 to 2018 for pancreatitis were identified. Every admission for pancreatitis in the first year after diagnosis was evaluated for a VTE (pulmonary embolism, deep vein thrombosis, or mesenteric vessel thrombosis) within 30 days of discharge. Characteristics of patients who developed a thromboembolic event were compared with those who did not.
Results:
There were 4613 patients with pancreatitis identified, 301 of whom developed a VTE (6.5%). Patients who developed a VTE were more likely to be male (P < 0.01), older (P = 0.03), and have an underlying coagulopathy (P < 0.01). Those with VTEs were more likely to die (27% vs 13%, P < 0.01), have more readmissions for pancreatitis (1.7 vs 1.3, P < 0.01), longer length of stay (16 vs 5.5 days, P < 0.01), and be discharged to acute or long-term rehabilitation rather than home (P < 0.01).
Conclusions:
Acute pancreatitis requiring hospitalization is associated with high risk of VTE in the first year after diagnosis. Thromboembolic disease is associated with worse morbidity and mortality.
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