TY - JOUR
T1 - Venous Thromboembolism Is Associated with Adverse Outcomes in Hospitalized Patients with Acute Pancreatitis
T2 - A Population-Based Cohort Study
AU - Trikudanathan, Guru
AU - Umapathy, Chandraprakash
AU - Munigala, Satish
AU - Gajendran, Mahesh
AU - Conwell, Darwin L.
AU - Freeman, Martin L.
AU - Krishna, Somashekar G.
N1 - Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Objectives The systemic inflammatory cascade and vascular stasis in hospitalized patients with acute pancreatitis (AP) serve as a milieu for development of venous thromboembolism (VTE). Our aim was to estimate the prevalence and risk factors of VTE in AP and to evaluate its impact on clinical outcomes of AP. Methods The Nationwide Inpatient Sample (2002-2011) was reviewed to identify all patients hospitalized with AP. Patients with a concomitant diagnosis of VTE were compared with those without. The primary clinical outcome (inpatient mortality) and secondary resources outcomes (length of stay and total hospital charges) were analyzed using univariate and multivariate comparisons. Results Among 2,382,426 patients with AP, 22,205 (0.93%) had VTE. Multivariate analysis showed patients with greater comorbidity (odds ratio [OR], 1.47), white race (OR, 1.11), acute kidney injury (OR, 1.08), acute respiratory failure (OR, 1.40), pseudocyst (OR, 1.41), total parenteral nutrition (OR, 1.28), and central venous catheter placement (OR, 3.01) were associated with a diagnosis of VTE. Venous thromboembolism was also independently associated with increased mortality (OR, 1.31) and prolonged duration of hospitalization by 6.5 days (P < 0.001) and contributed to an excess $44,882 (P < 0.001) in hospitalization costs. Conclusions Venous thromboembolism is adversely associated with mortality and health care resource utilization in AP.
AB - Objectives The systemic inflammatory cascade and vascular stasis in hospitalized patients with acute pancreatitis (AP) serve as a milieu for development of venous thromboembolism (VTE). Our aim was to estimate the prevalence and risk factors of VTE in AP and to evaluate its impact on clinical outcomes of AP. Methods The Nationwide Inpatient Sample (2002-2011) was reviewed to identify all patients hospitalized with AP. Patients with a concomitant diagnosis of VTE were compared with those without. The primary clinical outcome (inpatient mortality) and secondary resources outcomes (length of stay and total hospital charges) were analyzed using univariate and multivariate comparisons. Results Among 2,382,426 patients with AP, 22,205 (0.93%) had VTE. Multivariate analysis showed patients with greater comorbidity (odds ratio [OR], 1.47), white race (OR, 1.11), acute kidney injury (OR, 1.08), acute respiratory failure (OR, 1.40), pseudocyst (OR, 1.41), total parenteral nutrition (OR, 1.28), and central venous catheter placement (OR, 3.01) were associated with a diagnosis of VTE. Venous thromboembolism was also independently associated with increased mortality (OR, 1.31) and prolonged duration of hospitalization by 6.5 days (P < 0.001) and contributed to an excess $44,882 (P < 0.001) in hospitalization costs. Conclusions Venous thromboembolism is adversely associated with mortality and health care resource utilization in AP.
KW - acute pancreatitis
KW - deep vein thrombosis
KW - pulmonary embolus
KW - venous thromboembolism
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U2 - 10.1097/MPA.0000000000000906
DO - 10.1097/MPA.0000000000000906
M3 - Article
C2 - 28902787
AN - SCOPUS:85032621764
SN - 0885-3177
VL - 46
SP - 1165
EP - 1172
JO - Pancreas
JF - Pancreas
IS - 9
ER -