Venous Thromboembolism Is Associated With Adverse Outcomes in Hospitalized Patients With Acute Pancreatitis

医学 急性胰腺炎 优势比 共病 内科学 多元分析 单变量分析 重症监护医学 急诊医学
作者
Guru Trikudanathan,Chandraprakash Umapathy,Satish Munigala,Mahesh Gajendran,Darwin L. Conwell,Martin L. Freeman,Somashekar G. Krishna
出处
期刊:Pancreas [Lippincott Williams & Wilkins]
卷期号:46 (9): 1165-1172 被引量:14
标识
DOI:10.1097/mpa.0000000000000906
摘要

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.
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