Increased Morbidity and Mortality of Patients with Non-cirrhotic Portal Vein Thrombosis After Abdominal and Pelvic Surge
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ORIGINAL ARTICLE
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 Wuttiporn Manatsathit 1
&
Kishan Patel 2 & Thomas Enke 3 & Harlan Sayles 4 & Loretta L. Jophlin 5 & Shaheed Merani 6
Received: 6 August 2020 / Accepted: 1 October 2020 # 2020 The Society for Surgery of the Alimentary Tract
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 noncirrhotic 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. Keywords Portal vein thrombosis . Postoperative complication . Cirrhosis
Introduction With improvements in abdominal imaging techniques and an increase in its utilization, non-cirrhotic portal vein thrombosis
(NCPVT) has been increasingly detected. The incidence of PVT was estimated to be approximately 0.7 per 100,000 people per year.1 Unlike cirrhotic PVT (CPVT), NCPVT may be caused by multiple underlying etiologies, such as pregnancy,
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11605-020-04818-w) contains supplementary material, which is available to authorized users. * Wuttiporn Manatsathit [email protected] 1
2
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medica
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