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

被引:37
|
作者
Toque, Laurence [1 ,2 ]
Hamy, Antoine [1 ,2 ]
Hamel, Jean-Francois [2 ,3 ]
Cesbron, Elodie [4 ]
Hulo, Pauline [2 ]
Robert, Solen [2 ]
Aube, Christophe [1 ,5 ]
Lermite, Emilie [1 ,2 ]
Venara, Aurelien [1 ,2 ]
机构
[1] Univ Hosp Angers, Visceral & Endocrinal Surg Dept, 4 Rue Larrey, F-49933 Angers 9, France
[2] Univ Angers, LUNAM, Angers, France
[3] Univ Hosp Angers, Dept Biostat & Methodol, Angers, France
[4] Univ Hosp Angers, Dept Hepatogastroenterol, Angers, France
[5] Univ Angers, Dept Med Imaging, Angers, France
关键词
pancreatitis; risk factor; splanchnic vein; thrombosis; VENOUS THROMBOSIS; COMPLICATIONS;
D O I
10.1111/1751-2980.12298
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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 >10x10(9)/L (OR 6.397, P = 0.034), hyperglycemia (>= 10mmol/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.
引用
收藏
页码:734 / 740
页数:7
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