eGastroenterology
A clinical risk score for early thrombosis detection in acute and chronic pancreatitis: insights from a large cohort study
By Vielhauer J, Hausdorf A, Vornhuelz MG and 10 others.
Abstract
Background
Venous thromboembolism (VTE) is a major cause of preventable in-hospital mortality, yet disease-specific risk profiles remain poorly defined. In pancreatitis, one of the most common gastrointestinal causes of hospitalisation, thromboembolic complications are under-recognised, with limited data, especially on extrasplanchnic events. Evidence guiding screening and management remains scarce. We analysed VTE events in a large prospective cohort of patients with acute and chronic pancreatitis and derived a simple admission-time clinical risk score to support early identification of high-risk individuals.
Methods
We performed a retrospective analysis of a prospectively recruited cohort at LMU Klinikum Munich, a referral centre for pancreatic diseases. Patients with acute, acute-on-chronic or chronic pancreatitis evaluated between January 2018 and June 2023 were included. Comprehensive clinical, laboratory, imaging and outcome data were extracted. The primary objective was to identify admission-time factors associated with VTE and develop a clinically actionable risk score. Continuous variables were dichotomised using receiver operating characteristic (ROC)-derived optimal cut-points. Binary predictors were entered into a multivariable logistic regression model, and coefficients were scaled to generate an integer-based point score. Discrimination was assessed using the area under the ROC curve (AUC), and patients were stratified into low-risk, intermediate-risk and high-risk groups.