Abstract：
OBJECTIVE: We aimed to investigate the prevalence of vascular complications in acute pancreatitis (AP), to compare patient outcomes using various treatments, and to explore the related risk factors.
METHODS: Consecutive AP patients admitted from January 2010 to July 2017 were retrospectively included. Demographics, vascular complications, laboratory indices, and imaging findings were collected. Univariate and multivariate analyses were used to explore potential risk factors of vascular complications.
RESULTS: Of 3048 AP patients, 808 (26.5%) had vascular complications, including visceral vein thrombosis, sinistral portal hypertension, and arterial complications. And 38 (4.7%) patients received anticoagulant therapy and had a higher rate of recanalization (P < 0.001). Bleeding occurred in 95 (11.8%) patients, who received further treatment. Multivariate analysis identified male gender (odds ratio [OR] 1.650, 95% confidence interval [CI] 1.101-2.472), hyperlipidemia (OR 1.714, 95% CI 1.356-2.165), disease recurrence (OR 3.727, 95% CI 2.713-5.118), smoking (OR 1.519, 95% CI 1.011-2.283), hemoglobin level (OR 0.987, 95% CI 0.981-0.993), white blood cell (WBC) count (OR 1.094, 95% CI 1.068-1.122), non-vascular local complications (OR 3.018, 95% CI 1.992-4.573), computed tomography severity index (CTSI) (OR 1.425, 95% CI 1.273-1.596), and acute physiology and chronic health evaluation (APACHE) II score (OR 1.057, 95% CI 1.025-1.090) were related to vascular complications.
CONCLUSIONS: Vascular complications in AP is prevalent and their treatment is challenging. Further investigations are warranted to determine the optimal treatment strategy. Independent risk factors included male gender, hyperlipidemia, disease recurrence, smoking, WBC count, non-vascular local complications, CTSI, and APACHE II score.
METHODS: Consecutive AP patients admitted from January 2010 to July 2017 were retrospectively included. Demographics, vascular complications, laboratory indices, and imaging findings were collected. Univariate and multivariate analyses were used to explore potential risk factors of vascular complications.
RESULTS: Of 3048 AP patients, 808 (26.5%) had vascular complications, including visceral vein thrombosis, sinistral portal hypertension, and arterial complications. And 38 (4.7%) patients received anticoagulant therapy and had a higher rate of recanalization (P < 0.001). Bleeding occurred in 95 (11.8%) patients, who received further treatment. Multivariate analysis identified male gender (odds ratio [OR] 1.650, 95% confidence interval [CI] 1.101-2.472), hyperlipidemia (OR 1.714, 95% CI 1.356-2.165), disease recurrence (OR 3.727, 95% CI 2.713-5.118), smoking (OR 1.519, 95% CI 1.011-2.283), hemoglobin level (OR 0.987, 95% CI 0.981-0.993), white blood cell (WBC) count (OR 1.094, 95% CI 1.068-1.122), non-vascular local complications (OR 3.018, 95% CI 1.992-4.573), computed tomography severity index (CTSI) (OR 1.425, 95% CI 1.273-1.596), and acute physiology and chronic health evaluation (APACHE) II score (OR 1.057, 95% CI 1.025-1.090) were related to vascular complications.
CONCLUSIONS: Vascular complications in AP is prevalent and their treatment is challenging. Further investigations are warranted to determine the optimal treatment strategy. Independent risk factors included male gender, hyperlipidemia, disease recurrence, smoking, WBC count, non-vascular local complications, CTSI, and APACHE II score.
摘要：
目的：我们旨在调查急性胰腺炎（AP）血管并发症的患病率，为了比较使用各种治疗方法的患者结果，并探讨相关危险因素。
方法：回顾性纳入2010年1月至2017年7月连续收治的AP患者。人口统计,血管并发症,实验室指数,并收集影像学检查结果.采用单因素和多因素分析探讨血管并发症的潜在危险因素。
结果：在3048例AP患者中，808（26.5%）有血管并发症，包括内脏静脉血栓形成,左侧门静脉高压症,和动脉并发症。38例(4.7%)患者接受抗凝治疗后再通率较高(P<0.001)。95例（11.8%）患者发生出血，他接受了进一步的治疗。多变量分析确定了男性性别（优势比[OR]1.650，95%置信区间[CI]1.101-2.472），高脂血症（OR1.714，95%CI1.356-2.165），疾病复发（OR3.727，95%CI2.713-5.118），吸烟（OR1.519，95%CI1.011-2.283），血红蛋白水平（OR0.987，95%CI0.981-0.993），白细胞（WBC）计数（OR1.094，95%CI1.068-1.122），非血管局部并发症(OR3.018,95%CI1.992-4.573),计算机断层扫描严重度指数（CTSI）（OR1.425，95%CI1.273-1.596），急性生理和慢性健康评估（APACHE）II评分（OR1.057，95％CI1.025-1.090）与血管并发症有关。
结论：AP的血管并发症普遍存在，其治疗具有挑战性。需要进一步研究以确定最佳治疗策略。独立危险因素包括男性、高脂血症,疾病复发,吸烟,白细胞计数,非血管局部并发症,CTSI,和APACHEII得分。
方法：回顾性纳入2010年1月至2017年7月连续收治的AP患者。人口统计,血管并发症,实验室指数,并收集影像学检查结果.采用单因素和多因素分析探讨血管并发症的潜在危险因素。
结果：在3048例AP患者中，808（26.5%）有血管并发症，包括内脏静脉血栓形成,左侧门静脉高压症,和动脉并发症。38例(4.7%)患者接受抗凝治疗后再通率较高(P<0.001)。95例（11.8%）患者发生出血，他接受了进一步的治疗。多变量分析确定了男性性别（优势比[OR]1.650，95%置信区间[CI]1.101-2.472），高脂血症（OR1.714，95%CI1.356-2.165），疾病复发（OR3.727，95%CI2.713-5.118），吸烟（OR1.519，95%CI1.011-2.283），血红蛋白水平（OR0.987，95%CI0.981-0.993），白细胞（WBC）计数（OR1.094，95%CI1.068-1.122），非血管局部并发症(OR3.018,95%CI1.992-4.573),计算机断层扫描严重度指数（CTSI）（OR1.425，95%CI1.273-1.596），急性生理和慢性健康评估（APACHE）II评分（OR1.057，95％CI1.025-1.090）与血管并发症有关。
结论：AP的血管并发症普遍存在，其治疗具有挑战性。需要进一步研究以确定最佳治疗策略。独立危险因素包括男性、高脂血症,疾病复发,吸烟,白细胞计数,非血管局部并发症,CTSI,和APACHEII得分。
