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Increased Morbidity and Mortality of Patients with Non-cirrhotic Portal Vein Thrombosis After Abdominal and Pelvic Surgeries: a Study of the National Inpatient Sample 2002 to 2015

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

A higher rate of postoperative morbidity and mortality in patients with portal hypertension from cirrhosis is well recognized; however, the rate of postoperative morbidity and mortality among patients with portal hypertension from non-cirrhotic portal vein thrombosis (NCPVT) is largely unknown.

Method

All adults undergoing abdominal and pelvic surgery were identified from the National Inpatient Sample database from 2002 to 2015. Patients were then categorized into three groups: non-cirrhotic non-portal vein thrombosis (NCNPVT), NCPVT, and cirrhotic portal vein thrombosis (CPVT). Inpatient mortality, type of disposition, transfusions, length of stay, postoperative complications, and total charges were compared. Logistic regression and ordinary least squares regression analyses were performed for factors associated with inpatient mortality, transfusions, surgery-related complications, and log length of stay.

Results

Patients with NCPVT had significantly higher inpatient mortality rates, surgery-related complications, and longer length of stays compared with patients with NCNPVT (2.64% vs. 0.34%, 10.26% vs. 3.26%, 8 vs. 2 days) but less than patients with CPVT (2.64% vs. 6.31%, 10.26% vs. 17.48%, 8 vs. 11 days). In multiple logistic regression analyses, NCPVT groups remained associated with increased inpatient mortality rate, transfusions, and postoperative complications with odds ratios of 3.71 (1.88, 7.32), 3.43 (2.54, 4.62), and 3.08 (2.16, 4.39), respectively. NCPVT was also associated with 2.4 times increased length of stay.

Discussion

Patients with NCPVT had significantly higher risks of postoperative morbidity and mortality than patients with NCNPVT but less than patients with CPVT. Future studies with detail regarding the characteristics of PVTs are needed to confirm the findings in this study.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Wuttiporn Manatsathit

  2. Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA

    Kishan Patel

  3. Department of Internal Medicine, Northwestern University, Chicago, IL, USA

    Thomas Enke

  4. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA

    Harlan Sayles

  5. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Loretta L. Jophlin

  6. Division of Transplant Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA

    Shaheed Merani

Authors
  1. Wuttiporn Manatsathit
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  2. Kishan Patel
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  3. Thomas Enke
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  4. Harlan Sayles
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  5. Loretta L. Jophlin
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  6. Shaheed Merani
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Correspondence to Wuttiporn Manatsathit.

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All authors listed contributed substantially to the design of work, analysis, and interpretation of data, with input during drafting and final review of the version to be published. All authors agree to be accountable for all aspects of work.

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Manatsathit, W., Patel, K., Enke, T. et al. Increased Morbidity and Mortality of Patients with Non-cirrhotic Portal Vein Thrombosis After Abdominal and Pelvic Surgeries: a Study of the National Inpatient Sample 2002 to 2015. J Gastrointest Surg 25, 2026–2034 (2021). https://doi.org/10.1007/s11605-020-04818-w

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  • DOI: https://doi.org/10.1007/s11605-020-04818-w

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