Journal of Clinical Hepatology
People with acute necrotizing pancreatitis can develop blood clots in the deep veins of the legs. These clots may travel to the lungs and become life-threatening, making early identification of high-risk patients important.
Researchers retrospectively analysed 320 patients treated for acute necrotizing pancreatitis at two hospitals between 2013 and 2024. Twenty-five developed lower-extremity deep vein thrombosis during hospitalisation. After matching patients with and without thrombosis to reduce differences between the groups, the analysis included 24 patients with thrombosis and 112 controls.
Three factors were independently associated with thrombosis: a higher D-dimer level, a higher Bedside Index for Severity in Acute Pancreatitis (BISAP) score and more extensive pancreatic necrosis.
The researchers also compared three commonly used thrombosis-assessment systems: the Caprini, Padua and Wells scores. Combining the BISAP score, which measures pancreatitis severity, with the Caprini score, which assesses general thrombosis risk, provided the strongest discrimination.
The combined model had an area under the receiver operating characteristic curve of 0.832. At the selected threshold, it identified 75.0% of patients who developed thrombosis and correctly classified 91.1% of those who did not.
Acute necrotizing pancreatitis creates several conditions that favour blood-clot formation, including severe inflammation, immobility, vascular injury and abnormal coagulation. General thrombosis scores may not fully capture risks specifically related to pancreatic disease.
Combining the BISAP and Caprini scores brings together information about pancreatitis severity and established thrombosis risk factors. This may help clinicians decide which patients require closer ultrasound monitoring or preventive measures.
However, the study was retrospective, and only 25 patients developed thrombosis. The model was developed from patients at two hospitals in the same region and was not externally validated. Prospective multicentre studies are needed before it can be adopted as a standard clinical tool.
Objective: To investigate the influencing factors and independent risk factors for lower extremity deep vein thrombosis (DVT) in...
