Prevalence, treatment efficacy, and risk factors of vascular complications in acute pancreatitis: A case–control study

Objective

We aimed to investigate the prevalence of vascular complications in acute pancreatitis (AP), to compare patient outcomes using various treatments, and to explore the related risk factors.

Methods

Consecutive AP patients admitted from January 2010 to July 2017 were retrospectively included. Demographics, vascular complications, laboratory indices, and imaging findings were collected. Univariate and multivariate analyses were used to explore potential risk factors of vascular complications.

Results

Of 3048 AP patients, 808 (26.5%) had vascular complications, including visceral vein thrombosis, sinistral portal hypertension, and arterial complications. And 38 (4.7%) patients received anticoagulant therapy and had a higher rate of recanalization (P < 0.001). Bleeding occurred in 95 (11.8%) patients, who received further treatment. Multivariate analysis identified male gender (odds ratio [OR] 1.650, 95% confidence interval [CI] 1.101–2.472), hyperlipidemia (OR 1.714, 95% CI 1.356–2.165), disease recurrence (OR 3.727, 95% CI 2.713–5.118), smoking (OR 1.519, 95% CI 1.011–2.283), hemoglobin level (OR 0.987, 95% CI 0.981–0.993), white blood cell (WBC) count (OR 1.094, 95% CI 1.068–1.122), non-vascular local complications (OR 3.018, 95% CI 1.992–4.573), computed tomography severity index (CTSI) (OR 1.425, 95% CI 1.273–1.596), and acute physiology and chronic health evaluation (APACHE) II score (OR 1.057, 95% CI 1.025–1.090) were related to vascular complications.

Conclusions

Vascular complications in AP is prevalent and their treatment is challenging. Further investigations are warranted to determine the optimal treatment strategy. Independent risk factors included male gender, hyperlipidemia, disease recurrence, smoking, WBC count, non-vascular local complications, CTSI, and APACHE II score.