Abstract：
Portal vein thrombosis (PVT) is a rare complication of acute pancreatitis (AP) and might be associated with worse outcomes. We aimed to study trends, outcomes, and predictors of PVT in AP patients.
The National Inpatient Sample database was utilized to identify the adult patients (≥ 18 years) with primary diagnosis of AP from 2004 to 2013 using International Classification of Disease, Ninth Revision. Patients with and without PVT were entered into propensity matching model based on baseline variables. Outcomes were compared between both groups and predictors of PVT in AP were identified.
Among the total of 2,389,337 AP cases, 7046 (0.3%) had associated PVT. The overall mortality of AP decreased throughout the study period (p trend ≤ 0.0001), whereas mortality of AP with PVT remained stable (1-5.7%, p trend = 0.3). After propensity matching, AP patients with PVT patients had significantly higher in-hospital mortality (3.3% vs. 1.2%), AKI (13.4% vs. 7.7%), shock (6.9% vs. 2.5%), and need for mechanical ventilation (9.2% vs. 2.5%) along with mean higher cost of hospitalization and length of stay (p < 0.001 for all). Lower age (Odd ratio [OR] 0.99), female (OR 0.75), and gallstone pancreatitis (OR 0.79) were negative predictors, whereas alcoholic pancreatitis (OR 1.51), cirrhosis (OR 2.19), CCI > 2 (OR 1.81), and chronic pancreatitis (OR 2.28) were positive predictors of PVT (p < 0.001 for all) in AP patients.
PVT in AP is associated with significantly higher risk of death, AKI, shock, and need for mechanical ventilation. Chronic and alcoholic pancreatitis is associated with higher risk of PVT in AP.
The National Inpatient Sample database was utilized to identify the adult patients (≥ 18 years) with primary diagnosis of AP from 2004 to 2013 using International Classification of Disease, Ninth Revision. Patients with and without PVT were entered into propensity matching model based on baseline variables. Outcomes were compared between both groups and predictors of PVT in AP were identified.
Among the total of 2,389,337 AP cases, 7046 (0.3%) had associated PVT. The overall mortality of AP decreased throughout the study period (p trend ≤ 0.0001), whereas mortality of AP with PVT remained stable (1-5.7%, p trend = 0.3). After propensity matching, AP patients with PVT patients had significantly higher in-hospital mortality (3.3% vs. 1.2%), AKI (13.4% vs. 7.7%), shock (6.9% vs. 2.5%), and need for mechanical ventilation (9.2% vs. 2.5%) along with mean higher cost of hospitalization and length of stay (p < 0.001 for all). Lower age (Odd ratio [OR] 0.99), female (OR 0.75), and gallstone pancreatitis (OR 0.79) were negative predictors, whereas alcoholic pancreatitis (OR 1.51), cirrhosis (OR 2.19), CCI > 2 (OR 1.81), and chronic pancreatitis (OR 2.28) were positive predictors of PVT (p < 0.001 for all) in AP patients.
PVT in AP is associated with significantly higher risk of death, AKI, shock, and need for mechanical ventilation. Chronic and alcoholic pancreatitis is associated with higher risk of PVT in AP.
摘要：
背景：门静脉血栓形成（PVT）是急性胰腺炎（AP）的一种罕见并发症，可能与不良预后相关。我们旨在研究趋势，结果，以及AP患者PVT的预测因子。
方法：国家住院患者样本数据库用于识别2004年至2013年主要诊断为AP的成年患者（≥18岁），使用国际疾病分类，第九次修订。有和没有PVT的患者被输入基于基线变量的倾向匹配模型。比较两组之间的结果，并确定AP中PVT的预测因子。
结果：在总共2,389,337例AP中，7046（0.3％）与PVT相关。在整个研究期间，AP的总死亡率下降（p趋势≤0.0001），而伴有PVT的AP死亡率保持稳定(1-5.7%，p趋势=0.3)。在倾向匹配之后，合并PVT的AP患者的院内死亡率明显较高（3.3%vs.1.2%），AKI（13.4%vs.7.7%），冲击（6.9%对2.5%），并且需要机械通气(9.2%vs.2.5%）以及平均较高的住院费用和住院时间（全部p<0.001）。年龄较低（奇数比[OR]0.99），女性（OR0.75），胆结石性胰腺炎（OR0.79）是阴性预测因子，而酒精性胰腺炎（OR1.51），肝硬化（OR2.19），CCI>2(OR1.81)，和慢性胰腺炎（OR2.28）是AP患者PVT的阳性预测因子（全部p<0.001）。
结论：急性胰腺炎患者的PVT与更高的死亡风险相关，AKI,震惊,需要机械通气.慢性和酒精性胰腺炎与AP中PVT的高风险相关。
方法：国家住院患者样本数据库用于识别2004年至2013年主要诊断为AP的成年患者（≥18岁），使用国际疾病分类，第九次修订。有和没有PVT的患者被输入基于基线变量的倾向匹配模型。比较两组之间的结果，并确定AP中PVT的预测因子。
结果：在总共2,389,337例AP中，7046（0.3％）与PVT相关。在整个研究期间，AP的总死亡率下降（p趋势≤0.0001），而伴有PVT的AP死亡率保持稳定(1-5.7%，p趋势=0.3)。在倾向匹配之后，合并PVT的AP患者的院内死亡率明显较高（3.3%vs.1.2%），AKI（13.4%vs.7.7%），冲击（6.9%对2.5%），并且需要机械通气(9.2%vs.2.5%）以及平均较高的住院费用和住院时间（全部p<0.001）。年龄较低（奇数比[OR]0.99），女性（OR0.75），胆结石性胰腺炎（OR0.79）是阴性预测因子，而酒精性胰腺炎（OR1.51），肝硬化（OR2.19），CCI>2(OR1.81)，和慢性胰腺炎（OR2.28）是AP患者PVT的阳性预测因子（全部p<0.001）。
结论：急性胰腺炎患者的PVT与更高的死亡风险相关，AKI,震惊,需要机械通气.慢性和酒精性胰腺炎与AP中PVT的高风险相关。
