Splanchnic vein thrombosis in necrotizing pancreatitis : a post-hoc analysis of a nationwide prospective cohort
Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved..
BACKGROUND: Treatment guidelines for splanchnic vein thrombosis in necrotizing pancreatitis are lacking due to insufficient data on the full clinical spectrum.
METHODS: We performed a post-hoc analysis of a nationwide prospective necrotizing pancreatitis cohort. Multivariable analyses were used to identify risk factors and compare the clinical course of patients with and without SVT.
RESULTS: SVT was detected in 97 of the 432 included patients (22%) (median onset: 4 days). Risk factors were left, central, or subtotal necrosis (OR 28.52; 95% CI 20.11-40.45), right or diffuse necrosis (OR 5.76; 95% CI 3.89-8.51), and younger age (OR 0.94; 95% CI 0.90-0.97). Patients with SVT had higher rates of bleeding (n = 10,11%) and bowel ischemia (n = 4,4%) compared to patients without SVT (n = 14,4% and n = 2,0.6%; OR 3.24; 95% CI 1.27-8.23 and OR 7.29; 95% CI 1.31-40.4, respectively), and were independently associated with ICU admission (adjusted OR 2.53; 95% CI 1.37-4.68). Spontaneous recanalization occurred in 62% of patients (n = 40/71). Radiological and clinical outcomes did not differ between patients treated with and without anticoagulants.
DISCUSSION: SVT is a common and early complication of necrotizing pancreatitis, associated with parenchymal necrosis and younger age. SVT is associated with increased complications and a worse clinical course, whereas anticoagulant use does not appear to affect outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
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| Enthalten in: |
HPB : the official journal of the International Hepato Pancreato Biliary Association - 26(2024), 4 vom: 15. Apr., Seite 548-557 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sissingh, Noor J [VerfasserIn] |
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| Anmerkungen: |
Date Completed 01.04.2024 Date Revised 01.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.hpb.2024.01.011 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368260976 |
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| 100 | 1 | |a Sissingh, Noor J |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Splanchnic vein thrombosis in necrotizing pancreatitis |b a post-hoc analysis of a nationwide prospective cohort |
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| 520 | |a Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a BACKGROUND: Treatment guidelines for splanchnic vein thrombosis in necrotizing pancreatitis are lacking due to insufficient data on the full clinical spectrum | ||
| 520 | |a METHODS: We performed a post-hoc analysis of a nationwide prospective necrotizing pancreatitis cohort. Multivariable analyses were used to identify risk factors and compare the clinical course of patients with and without SVT | ||
| 520 | |a RESULTS: SVT was detected in 97 of the 432 included patients (22%) (median onset: 4 days). Risk factors were left, central, or subtotal necrosis (OR 28.52; 95% CI 20.11-40.45), right or diffuse necrosis (OR 5.76; 95% CI 3.89-8.51), and younger age (OR 0.94; 95% CI 0.90-0.97). Patients with SVT had higher rates of bleeding (n = 10,11%) and bowel ischemia (n = 4,4%) compared to patients without SVT (n = 14,4% and n = 2,0.6%; OR 3.24; 95% CI 1.27-8.23 and OR 7.29; 95% CI 1.31-40.4, respectively), and were independently associated with ICU admission (adjusted OR 2.53; 95% CI 1.37-4.68). Spontaneous recanalization occurred in 62% of patients (n = 40/71). Radiological and clinical outcomes did not differ between patients treated with and without anticoagulants | ||
| 520 | |a DISCUSSION: SVT is a common and early complication of necrotizing pancreatitis, associated with parenchymal necrosis and younger age. SVT is associated with increased complications and a worse clinical course, whereas anticoagulant use does not appear to affect outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Anticoagulants |2 NLM | |
| 700 | 1 | |a Timmerhuis, Hester C |e verfasserin |4 aut | |
| 700 | 1 | |a Groen, Jesse V |e verfasserin |4 aut | |
| 700 | 1 | |a de Jong, Mike J P |e verfasserin |4 aut | |
| 700 | 1 | |a Besselink, Marc G |e verfasserin |4 aut | |
| 700 | 1 | |a Boekestijn, Bas |e verfasserin |4 aut | |
| 700 | 1 | |a Bollen, Thomas L |e verfasserin |4 aut | |
| 700 | 1 | |a Bonsing, Bert A |e verfasserin |4 aut | |
| 700 | 1 | |a Bouwense, Stefan A W |e verfasserin |4 aut | |
| 700 | 1 | |a Hazen, Wouter L |e verfasserin |4 aut | |
| 700 | 1 | |a Klok, Frederikus A |e verfasserin |4 aut | |
| 700 | 1 | |a van Santvoort, Hjalmar C |e verfasserin |4 aut | |
| 700 | 1 | |a van Eijck, Casper H J |e verfasserin |4 aut | |
| 700 | 1 | |a Verdonk, Robert C |e verfasserin |4 aut | |
| 700 | 1 | |a Mieog, J Sven D |e verfasserin |4 aut | |
| 700 | 1 | |a van Hooft, Jeanin E |e verfasserin |4 aut | |
| 700 | 0 | |a Dutch Pancreatitis Study Group |e verfasserin |4 aut | |
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