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

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Abstract

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.

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Acknowledgments

We would like to thank Dr. Yashwant Raj Sakaray, Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh for providing support in data collection during the present study.

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Authors and Affiliations

  1. Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Terence Susngi

  2. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Terence Susngi, Jimil Shah, Vaneet Jearth, Anupam K. Singh, Harshal S. Mandavdhare, Vishal Sharma, Surinder Rana & Usha Dutta

  3. Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Harish Bhujade

  4. Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Rajesh Gupta

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  1. Terence Susngi
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  2. Jimil Shah
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Contributions

TS, JS: Concept of study, data acquisition, critically revising the manuscript. HB, AKS: Interpretation of data, critically revising the manuscript. VJ, HSM, VS: Data acquisition, critically revising the manuscript. RG, SR, UD: Data acquisition, Interpretation of data. Final approval of manuscript: All authors.

Corresponding author

Correspondence to Jimil Shah.

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Susngi, T., Shah, J., Bhujade, H. et al. Deep Venous Thrombosis in Acute Pancreatitis Is Associated with High Mortality: A Prospective Study. Dig Dis Sci 68, 988–994 (2023). https://doi.org/10.1007/s10620-022-07617-2

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  • DOI: https://doi.org/10.1007/s10620-022-07617-2

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