P4350 - Increased Risk of Venous Thromboembolism in Hospitalized Acute Pancreatitis Patients: A National Analysis

Ali Osman, MD, MSCI Candidate¹, Mohamed Abdallah, MD², Mohammad Bilal, MD, FACG³
1Washington University School of Medicine in St. Louis, Ballwin, MO; 2Corewell Health, Royal Oak, MI; 3University of Colorado Anschutz Medical Campus, Denver, CO

Introduction: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a known complication of systemic inflammation and immobility during hospitalization. However, the magnitude of VTE risk in patients with acute pancreatitis (AP) compared to the general hospitalized population remains understudied. We aim to compare the 90-day risk of DVT and PE in patients hospitalized with acute pancreatitis

Methods: We conducted a retrospective cohort study using the TriNetX Global Collaborative Network. Adults (≥18 years) hospitalized with acute pancreatitis (Cohort 1) were compared to propensity score–matched hospitalized controls without pancreatitis (Cohort 2), matched 1:1 on demographics and comorbidities. Patients with prior history of VTE or chronic pancreatitis were excluded. The index event was the hospitalization, and outcomes were measured from day 1 through day 90 post-index. Kaplan-Meier survival and risk analyses were performed, excluding patients with VTE prior to the time window.

Results: After matching, 138,739 patients were included in each cohort.

· The incidence of: DVT was significantly higher in the AP cohort (0.1%) vs. control (0.007%) with a risk ratio of 13.95 (95% CI: 7.34–26.49) and a hazard ratio of 44.18 (95% CI: 14.08–138.65); p< 0.001.

· The incidence of PE was also higher in the AP group (0.2%) vs. control (0.05%), with a risk ratio of 4.39 (95% CI: 3.42–5.63) and a hazard ratio of 4.18 (95% CI: 3.26–5.37); p< 0.001.
Kaplan-Meier survival analysis showed significantly lower VTE-free survival in the AP cohort for both outcomes.

Discussion: Patients hospitalized with acute pancreatitis have a significantly increased risk of both DVT and PE within 90 days of admission compared to other hospitalized patients, even after adjusting for confounders. These findings support consideration of VTE prophylaxis strategies in these patients.


Figure: Table 1. Baseline Characteristics After Propensity Score Matching (N = 138,739 per Cohort)


Figure: Fig-1: Risk of DVT/PE and 90-days VTE-Free Survival

Disclosures:
Ali Osman indicated no relevant financial relationships.
Mohamed Abdallah indicated no relevant financial relationships.
Mohammad Bilal: Boston Scientific – Consultant. Cook endoscopy – Paid speaker. Steris Endoscopy – Consultant.

Ali Osman, MD, MSCI Candidate¹, Mohamed Abdallah, MD², Mohammad Bilal, MD, FACG³. P4350 - Increased Risk of Venous Thromboembolism in Hospitalized Acute Pancreatitis Patients: A National Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.