Objectives The systemic inflammatory cascade and vascular stasis in hospitalized patients with acute pancreatitis (AP) serve as a milieu for development of venous thromboembolism (VTE). Our aim was to estimate the prevalence and risk factors of VTE in AP and to evaluate its impact on clinical outcomes of AP. Methods The Nationwide Inpatient Sample (2002-2011) was reviewed to identify all patients hospitalized with AP. Patients with a concomitant diagnosis of VTE were compared with those without. The primary clinical outcome (inpatient mortality) and secondary resources outcomes (length of stay and total hospital charges) were analyzed using univariate and multivariate comparisons. Results Among 2,382,426 patients with AP, 22,205 (0.93%) had VTE. Multivariate analysis showed patients with greater comorbidity (odds ratio [OR], 1.47), white race (OR, 1.11), acute kidney injury (OR, 1.08), acute respiratory failure (OR, 1.40), pseudocyst (OR, 1.41), total parenteral nutrition (OR, 1.28), and central venous catheter placement (OR, 3.01) were associated with a diagnosis of VTE. Venous thromboembolism was also independently associated with increased mortality (OR, 1.31) and prolonged duration of hospitalization by 6.5 days (P < 0.001) and contributed to an excess $44,882 (P < 0.001) in hospitalization costs. Conclusions Venous thromboembolism is adversely associated with mortality and health care resource utilization in AP.
Bibliographical noteFunding Information:
The Nationwide Inpatient Sample (NIS) is an all-payer, administrative claims-based database maintained as part of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality (AHRQ).7 It is a data compilation of more than 8 million inpatient admissions annually from approximately 1000 hospitals in the United States. These databases reflect a 20% stratified sample of nonfederal, acute-care hospitals in the United States. The sampling frame includes community and general hospitals and academic medical centers in the United States.
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- acute pancreatitis
- deep vein thrombosis
- pulmonary embolus
- venous thromboembolism