Predictive factors of splanchnic vein thrombosis in acute pancreatitis: A 6‐year single‐center experience

Abstract

OBJECTIVE: Splanchnic vein thrombosis (SVT) is a potentially severe complication of pancreatitis. The aim of this single-center, retrospective cohort study was to investigate the incidence of SVT and to determine the connected risk factors.METHODS: All consecutive patients with acute pancreatitis (AP) managed in our hospital were included. The primary outcome was the occurrence of SVT and data was collected in accordance with Ranson's criteria. RESULTS:A total of 318 patients were included, of whom 124 (39.0%) were women. Biliary lithiasis was the main cause of pancreatitis (n = 156, 49.1%). A total of 19 (6.0%) SVT were identified. In univariate analysis, alcohol intake, smoking and male gender were associated with SVT (P = 0.005, 0.003 and 0.007, respectively).Biological parameters significantly associated with thrombosis were lactate dehydrogenase (LDH) < 500 U/L and hyperglycemia (≥ 10 mmol/L) (P = 0.009 and 0.016, respectively).In multivariate analysis, prothrombin time >75% was a protective factor against thrombosis (OR 0.148, P = 0.019). Leukocytes >10 × 10 9 /L (OR 6.397, P = 0.034), hyperglycemia (≥ 10 mmol/L) (OR 6.845, P = 0.023), LDH < 500 U/L ((OR 22.61, P = 0.001) and alcoholic etiology (OR 8.960, P = 0.041) were risk factors for SVT.CONCLUSIONS: Alcohol intake, male gender and smoking should focus the physician's attention on the risk of SVT. When further associated with certain biological parameters, the physicians should consider therapeutic anticoagulation to prevent SVT. LDH, lactate dehydrogenase; SGOT, serum glutamic oxaloacetic transaminase. Prothrombin time is expressed after normalized to the normal level. Journal of Digestive Diseases 2015; 16; 734-740 738 L Toqué et al.

Serum Concentrations of Angiopoietin-2 and Soluble fms-Like Tyrosine Kinase 1 (sFlt-1) Are Associated with Coagulopathy among Patients with Acute Pancreatitis

“…Indeed, several authors reported clinically significant DIC as a complication of AP [16,18,32]. However, other coagulopathies were also observed in the course of AP, such a localized thrombosis and pulmonary embolism [33,34,35,36,37] or thrombotic thrombocytopenic purpura [17,38]. The diagnosis of DIC in AP patients is further complicated by the fact that acute inflammation is a known factor leading to an increase in platelet counts [39], fibrinogen, and D-dimer concentrations [30].…”

The Interplay between Inflammation, Coagulation and Endothelial Injury in the Early Phase of Acute Pancreatitis: Clinical Implications

“…Consequently, various clinically relevant thrombotic complications are observed in human AP, ranging from localized thrombosis [155,156,157,158] and pulmonary thromboembolism [159] to DIC [153,160]. Both thrombotic and hemorrhagic complications were associated with deaths due to AP [27].…”

Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis

“…There is little data regarding the risk factors for this complication in the early stage of AP. The results about the risk factors of PSMVT in AP patients vary among studies[ 3 , 5 , 7 - 10 ]. Therefore, in this study, we analyzed the data to explore the incidence of PSMVT in the early stage of severe AP (SAP), the risk factors for the development of PSMVT, and the clinical outcomes of PSMVT.…”