Deep Venous Thrombosis in Acute Pancreatitis Is Associated with High Mortality: A Prospective Study

被引:2
作者
Susngi, Terence [1 ,2 ]
Shah, Jimil [2 ]
Bhujade, Harish [3 ]
Jearth, Vaneet [2 ]
Singh, Anupam K. [2 ]
Mandavdhare, Harshal S. [2 ]
Sharma, Vishal [2 ]
Gupta, Rajesh [4 ]
Rana, Surinder [2 ]
Dutta, Usha [2 ]
机构
[1] Postgrad Inst Med Educ & Res PGIMER, Dept Internal Med, Chandigarh, India
[2] Postgrad Inst Med Educ & Res PGIMER, Dept Gastroenterol, Chandigarh, India
[3] Postgrad Inst Med Educ & Res PGIMER, Dept Radiodiag & Imaging, Chandigarh, India
[4] Postgrad Inst Med Educ & Res PGIMER, Dept Surg Gastroenterol, Chandigarh, India
关键词
Necrotizing pancreatitis; Thrombosis; Well's score; Padua's score; Splanchnic venous thrombosis; VEIN THROMBOSIS; MANAGEMENT; THROMBOEMBOLISM; RISK;
D O I
10.1007/s10620-022-07617-2
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Incidence and risk factors for the development of extremity deep vein thrombosis (eDVT) in admitted patients of acute pancreatitis have been rarely explored. Aims To identify the incidence of eDVT and to explore role of clinical scores for predicting eDVT in admitted patients of acute pancreatitis. Methods We prospectively enrolled admitted patients of acute pancreatitis and performed a weekly eDVT screen for the duration of their admission. Well's score and Padua's score were also calculated weekly. The incidence of venous thrombosis (eDVT and splanchnic thrombosis based on contrast-enhanced CT scan abdomen) was noted, and the risk factors were determined using multivariate analysis. The correlation between Well's score, Padua's score, and development of DVT was calculated using Pearson's correlation. Results Of the 102 patients of acute pancreatitis enrolled, 73.5% of patients had necrotizing pancreatitis. Total of 46 patients (45.1%) developed thrombosis: 43 patients had splanchnic vein thrombosis; 5 patients had eDVT; and 1 patient had pulmonary embolism. Patients with eDVT had higher BISAP score (2.6 +/- 0.9 vs 1.7 +/- 0.8; p = 0.039), requirement of mechanical ventilation (60% vs 8.2%; p = 0.008), and mortality (60% vs 12.4%; p = 0.022). Well's score of >= 2 had sensitivity and specificity of 80% and 96.9% for prediction of eDVT and it had better correlation with the development of eDVT compared to Pauda's score. Conclusion Incidence of DVT is 5% in patients with acute pancreatitis requiring admission. It is associated with higher disease severity and mortality. The Well's score is useful to predict the development of eDVT in routine clinical practice.
引用
收藏
页码:988 / 994
页数:7
相关论文
共 19 条
[1]   Risk of Venous Thromboembolism in Acute Necrotizing Pancreatitis A Large Database Study [J].
Ahmad, Dina S. ;
Mansoor, Emad ;
Alikhan, Muhammed M. ;
Rana, Mariam Nadeem ;
Panhwar, Muhammad Siyab ;
Wong, Richard C. K. ;
Smith, Zachary L. .
PANCREAS, 2021, 50 (01) :71-76
[2]   Role of thrombophilia in splanchnic venous thrombosis in acute pancreatitis [J].
Ahmed, Sobur Uddin ;
Rana, Surinder S. ;
Ahluwalia, Jasmina ;
Varma, Neelam ;
Sharma, Ravi ;
Gupta, Rajesh ;
Kang, Mandeep .
ANNALS OF GASTROENTEROLOGY, 2018, 31 (03) :371-378
[3]   Endoscopic management of acute necrotizing pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines [J].
Arvanitakis, Marianna ;
Dumonceau, Jean-Marc ;
Albert, Joerg ;
Badaoui, Abdenor ;
Bali, Maria Antonietta ;
Barthet, Marc ;
Besselink, Marc ;
Deviere, Jacques ;
Ferreira, Alexandre Oliveira ;
Gyokeres, Tibor ;
Hritz, Istvan ;
Hucl, Tomas ;
Milashka, Marianna ;
Papanikolaou, Ioannis S. ;
Poley, Jan-Werner ;
Seewald, Stefan ;
Vanbiervliet, Geoffroy ;
van Lienden, Krijn ;
van Santvoort, Hjalmar ;
Voermans, Rogier ;
Delhaye, Myriam ;
van Hooft, Jeanin .
ENDOSCOPY, 2018, 50 (05) :524-546
[4]   Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus [J].
Banks, Peter A. ;
Bollen, Thomas L. ;
Dervenis, Christos ;
Gooszen, Hein G. ;
Johnson, Colin D. ;
Sarr, Michael G. ;
Tsiotos, Gregory G. ;
Vege, Santhi Swaroop .
GUT, 2013, 62 (01) :102-111
[5]   American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis [J].
Baron, Todd H. ;
DiMaio, Christopher J. ;
Wang, Andrew Y. ;
Morgan, Katherine A. .
GASTROENTEROLOGY, 2020, 158 (01) :67-+
[6]   Mesenteric venous thrombosis: Diagnosis and noninvasive imaging [J].
Bradbury, MS ;
Kavanagh, PV ;
Bechtold, RE ;
Chen, MY ;
Ott, DJ ;
Regan, JD ;
Weber, TM .
RADIOGRAPHICS, 2002, 22 (03) :527-541
[7]   American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis [J].
Crockett, Seth D. ;
Wani, Sachin ;
Gardner, Timothy B. ;
Falck-Ytter, Yngve ;
Barkun, Alan N. .
GASTROENTEROLOGY, 2018, 154 (04) :1096-1101
[8]   Portosplenomesenteric Venous Thrombosis in Patients With Acute Pancreatitis Is Associated With Pancreatic Necrosis and Usually Has a Benign Course [J].
Easler, Jeffrey ;
Muddana, Venkata ;
Furlan, Alessandro ;
Dasyam, Anil ;
Vipperla, Kishore ;
Slivka, Adam ;
Whitcomb, David C. ;
Papachristou, Georgios I. ;
Yadav, Dhiraj .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2014, 12 (05) :854-862
[9]   Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis [J].
Gatot, D. ;
Mardia, A. I. .
1ST INT CONF ON TROP MED & INFECT DIS FAC OF MED UNIV SUMATERA UTARA IN CONJUNCTION WITH THE 23RD NATL CONGRESS OF THE INDONESIAN SOC OF TROP & INFECT DIS CONSULTANT AND THE 18TH ANNUAL MEETING OF INTERNAL MED DEPT FAC OF MED UNIV SUMATERA UTARA, 2018, 125
[10]   Deep Vein Thrombosis of the Upper Extremity [J].
Heil, Jan ;
Miesbach, Wolfgang ;
Vogl, Thomas ;
Bechstein, Wolf O. ;
Reinisch, Alexander .
DEUTSCHES ARZTEBLATT INTERNATIONAL, 2017, 114 (14) :244-249