Cargando…

Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis

AIM: To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis (PSMVT) in the early stage of severe acute pancreatitis (SAP). METHODS: Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced com...

Descripción completa

Detalles Bibliográficos
Autores principales: Ding, Ling, Deng, Feng, Yu, Chen, He, Wen-Hua, Xia, Liang, Zhou, Mi, Huang, Xin, Lei, Yu-Peng, Zhou, Xiao-Jiang, Zhu, Yin, Lu, Nong-Hua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148429/
https://www.ncbi.nlm.nih.gov/pubmed/30254409
http://dx.doi.org/10.3748/wjg.v24.i35.4054
_version_ 1783356743056621568
author Ding, Ling
Deng, Feng
Yu, Chen
He, Wen-Hua
Xia, Liang
Zhou, Mi
Huang, Xin
Lei, Yu-Peng
Zhou, Xiao-Jiang
Zhu, Yin
Lu, Nong-Hua
author_facet Ding, Ling
Deng, Feng
Yu, Chen
He, Wen-Hua
Xia, Liang
Zhou, Mi
Huang, Xin
Lei, Yu-Peng
Zhou, Xiao-Jiang
Zhu, Yin
Lu, Nong-Hua
author_sort Ding, Ling
collection PubMed
description AIM: To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis (PSMVT) in the early stage of severe acute pancreatitis (SAP). METHODS: Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced computed tomography (CT) studies were reassessed and reviewed. Clinical outcome measures were compared between SAP patients with and without PSMVT in the early stage of the disease. Univariate and multivariate logistic regression analyses were sequentially performed to assess potential risk factors for the development of PSMVT in SAP patients. A receiver operating characteristic (ROC) curve was generated for the qualifying independent risk factors. RESULTS: Twenty-five of the one hundred and forty (17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after acute pancreatitis (AP) onset. PSMVT was confirmed by contrast-enhanced CT. Multivariate stepwise logistic regression analyses showed that Balthazar’s CT severity index (CTSI) scores [odds ratio (OR): 2.742; 95% confidence interval (CI): 1.664-4.519; P = 0.000], hypoalbuminemia (serum albumin level < 25 g/L) (OR: 32.573; 95%CI: 2.711-391.353; P = 0.006) and gastrointestinal wall thickening (OR: 4.367, 95%CI: 1.218-15.658; P = 0.024) were independent risk factors for PSMVT developed in patients with SAP. The area under the ROC curve for Balthazar’s CTSI scores was 0.777 (P = 0.000), the sensitivity was 52%, and the specificity was 93% at a cut-off value of 5.5. CONCLUSION: High Balthazar’s CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP.
format Online
Article
Text
id pubmed-6148429
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-61484292018-09-25 Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis Ding, Ling Deng, Feng Yu, Chen He, Wen-Hua Xia, Liang Zhou, Mi Huang, Xin Lei, Yu-Peng Zhou, Xiao-Jiang Zhu, Yin Lu, Nong-Hua World J Gastroenterol Retrospective Cohort Study AIM: To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis (PSMVT) in the early stage of severe acute pancreatitis (SAP). METHODS: Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced computed tomography (CT) studies were reassessed and reviewed. Clinical outcome measures were compared between SAP patients with and without PSMVT in the early stage of the disease. Univariate and multivariate logistic regression analyses were sequentially performed to assess potential risk factors for the development of PSMVT in SAP patients. A receiver operating characteristic (ROC) curve was generated for the qualifying independent risk factors. RESULTS: Twenty-five of the one hundred and forty (17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after acute pancreatitis (AP) onset. PSMVT was confirmed by contrast-enhanced CT. Multivariate stepwise logistic regression analyses showed that Balthazar’s CT severity index (CTSI) scores [odds ratio (OR): 2.742; 95% confidence interval (CI): 1.664-4.519; P = 0.000], hypoalbuminemia (serum albumin level < 25 g/L) (OR: 32.573; 95%CI: 2.711-391.353; P = 0.006) and gastrointestinal wall thickening (OR: 4.367, 95%CI: 1.218-15.658; P = 0.024) were independent risk factors for PSMVT developed in patients with SAP. The area under the ROC curve for Balthazar’s CTSI scores was 0.777 (P = 0.000), the sensitivity was 52%, and the specificity was 93% at a cut-off value of 5.5. CONCLUSION: High Balthazar’s CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP. Baishideng Publishing Group Inc 2018-09-21 2018-09-21 /pmc/articles/PMC6148429/ /pubmed/30254409 http://dx.doi.org/10.3748/wjg.v24.i35.4054 Text en ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Cohort Study
Ding, Ling
Deng, Feng
Yu, Chen
He, Wen-Hua
Xia, Liang
Zhou, Mi
Huang, Xin
Lei, Yu-Peng
Zhou, Xiao-Jiang
Zhu, Yin
Lu, Nong-Hua
Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis
title Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis
title_full Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis
title_fullStr Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis
title_full_unstemmed Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis
title_short Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis
title_sort portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis
topic Retrospective Cohort Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6148429/
https://www.ncbi.nlm.nih.gov/pubmed/30254409
http://dx.doi.org/10.3748/wjg.v24.i35.4054
work_keys_str_mv AT dingling portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT dengfeng portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT yuchen portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT hewenhua portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT xialiang portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT zhoumi portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT huangxin portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT leiyupeng portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT zhouxiaojiang portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT zhuyin portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis
AT lunonghua portosplenomesentericveinthrombosisinpatientswithearlystagesevereacutepancreatitis