Resident Creighton University Arizona Health Education Alliance Phoenix, Arizona
Ishani Shah, MD1, Abhishek Bhurwal, MBBS, MD2, Harsh Mehta, MD3, Savio Reddymasu, MD1; 1Creighton University Arizona Health Education Alliance, Phoenix, AZ; 2Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ; 3Saint Barnabas Medical Center, West Orange, NJ
Introduction: Obesity and chronic pancreatitis (CP) have been associated with an increased risk of venous thromboembolism (VTE) among hospitalized patients. Limited data exists related to the effect of obesity on CP-related complications, including VTE. The aim of our study was to assess the effect of obesity on VTE-related outcomes among patients with CP. Methods: All adults hospitalized with CP and VTE during the years 2010 to 2014, were identified using the Nationwide Inpatient Sample (NIS). These patients were divided into two groups: patients who were overweight, obese or morbidly obese (study group) and those with normal BMI (control group). We compared demographic characteristics, inpatient mortality, length of stay and total charges associated with hospitalization between these groups. Results: There were 16,089 hospitalizations for patients with CP who also had a co-diagnosis of VTE. Of these, the proportion of obese patients increased over the years (Figure 1). Demographic characteristics of patients from both groups are described in table 1. Comorbidities such as diabetes (39.96% vs 35.53%; p=0.43), hypertension (74.96% vs 52.43%; p< 0.001) and dyslipidemia (37.75% vs 21.24%; p=0.001) were more prevalent in obese patients. Complications associated with pulmonary embolism (PE) such as cardiogenic shock (1.69 vs 0.59; p=0.4), right heart failure (15.37% vs 9.29%; p=0.06) and respiratory failure (25.08% vs 20.18%; p=0.8) were higher in the obese group of patients. Length of stay (13.40 days vs 10.47 days; p< 0.001), inpatient mortality (6.96% vs 5.45%; p=0.02) and total cost of hospitalization ($123,240 vs $94,848; p< 0.001) were higher among obese patients compared to controls. On multivariate logistic regression, obesity was associated with increased odds of mortality (OR 1.75 [1.42 to 2.13]; p=0.4) but did not show an association with length of stay (OR -0.19 [-0.42 to 0.49]; p=0.1) among hospitalized CP patients with VTE. Discussion: CP has been known to be associated with VTE, especially porto-splenic thromboembolism, which can often lead to thrombus dissipation and life-threatening PE. Our study identifies obesity as a superimposed risk factor leading to a higher rate of morbidity and mortality among CP patients who are hospitalized with VTE. With the prevalence of obesity on a rise among these patients, it is important for clinicians to understand this correlation and institute appropriate weight loss and clot-prophylactic measures among such patients.
Trend of obese patients with chronic pancreatitis admitted with venous thromboembolism
Characteristics and outcomes among patients with chronic pancreatitis and VTE with and without obesity
Disclosures: Ishani Shah indicated no relevant financial relationships. Abhishek Bhurwal indicated no relevant financial relationships. Harsh Mehta indicated no relevant financial relationships. Savio Reddymasu indicated no relevant financial relationships.