S147 Acute Necrotizing Pancreatitis Is Associated With an Increased Risk of Venous Thromboembolism: A Systematic Review and Meta-Analysis

Introduction: Acute pancreatitis is a leading cause of hospital admissions in the United States. Up to 20% of acute pancreatitis cases can progress to acute necrotizing pancreatitis (ANP). Inflammation-induced dysregulation of the coagulation cascade and vascular stasis in hospitalized patients with ANP serve as a milieu for venous thromboembolism (VTE). Deep vein thrombosis (DVT) and pulmonary embolism are often underrecognized. In this meta-analysis, we have evaluated the incidence of VTE and associated worse outcomes in patients with ANP. Methods: We reviewed several databases from inception to April 28, 2025, to identify studies that reported the incidence of VTE in patients with ANP. Our outcomes of interest were the rate of VTE, DVT, pulmonary embolism, and splanchnic venous thrombosis, and comparison of all-cause mortality, intensive care admissions, and organ failure in ANP patients with and without venous thrombosis. We calculated pooled rates with 95% confidence intervals (CI) for our outcomes of interest. Pooled odds ratios (OR) with 95% CI were calculated for comparatives outcomes. Data was analyzed using random-effects model. Heterogeneity was assessed using I2 statistic. Results: We included 8 studies with 83425 patients with ANP. The mean age of the patients was 51.6 (1.9) years. Pooled rates (95% CI) of VTE in patients with the ANP were 15% (6.7%, 32%). Pooled rates (95% CI) of DVT in patients with the ANP group were 7.4% (1%, 30%). Pooled rates (95% CI) of pulmonary embolism in patients with the ANP group were 3% (1%, 6.6%). Pooled rates (95% CI) of splanchnic venous thrombosis in patients with the ANP were 29% (10%, 58%). Rates of all-cause mortality, OR 1.50 (1.06, 2.11), P = 0.02, I² = 91% and intensive care admissions, OR 1.86 (1.78, 1.95), P < 0.00001, I² = 0% were significantly higher in VTE group compared to no VTE group. Conclusion: Patients with ANP are at increased risk of VTE. VTE is associated with elevated risk of mortality and intensive care admissions in patients with ANP.