P2889 - Impact of Non-Alcoholic Fatty Liver Disease on Mortality and Morbidity in Pancreatic Cancer Population Presenting With Venous Thromboembolism

Anuroop Yekula, MD, Ankushi Sanghvi, MD, Aakriti Soni, MD
Saint Vincent Hospital, Worcester, MA

Introduction: Nonalcoholic fatty liver disease is an emerging cause of chronic liver disease worldwide. Common extrahepatic manifestations often include cardiovascular diseases, endocrinopathies, and venous thromboembolism. Pancreatic cancer accounts for about 3.2% of all new cancers in the US. Studies have shown a strong association of pancreatic cancer with venous thromboembolism (VTE). We aim to estimate the effect of NAFLD on VTE prevalence, mortality, and healthcare utilization in this population.

Methods: We queried the National Inpatient Sample (NIS) 2016-2019 for all adult patients diagnosed with pancreatic cancer. The cohort was further classified by the presence of VTE (either deep vein thrombosis (DVT) or pulmonary embolism (PE)). The primary outcome of interest was in-hospital mortality, and secondary outcomes included hospitalization cost and length of stay, reflecting resource utilization. Multivariable regression analysis was performed to examine the association.

Results: Over a period of 4 years, 486,744 admissions were identified with a diagnosis of pancreatic cancer. The mean age was 68 years, and 48% were females. The prevalence of acute DVT and PE was 5.0% and 5.8%, respectively. The odds of all-cause mortality in pancreatic cancer from acute PE were higher in the NAFLD population, OR 1.897, 95% CI 1.268 - 2.837, p=0.002. Although DVT-related mortality was higher in the NAFLD group, it was not statistically significant, OR 1.152, 95% CI 0.857 - 1.496, p=0.290. NAFLD and VTE were also associated with higher hospital costs, with $ 23,373 for DVT, $ 5,857 for PE, and a longer mean hospital stay (0.67 days).

Discussion: Our study suggests that NAFLD has increased mortality, hospitalizations, resource utilization, and increased length of stay in patients having PEs with underlying pancreatic cancers. Although resource utilization and length of stay were higher in the acute DVT group, there was no statistically significant increase in mortality in this population. Current guidelines (2020) recommend against offering thromboprophylaxis to patients with any cancer. Large, multicenter, and prospective studies are needed to further study these associations and the associated risk of morbidity and mortalities to formulate risk assessment models for primary thromboprophylaxis in pancreatic cancer in liver disease.


Disclosures:


Anuroop Yekula, MD, Ankushi Sanghvi, MD, Aakriti Soni, MD. P2889 - Impact of Non-Alcoholic Fatty Liver Disease on Mortality and Morbidity in Pancreatic Cancer Population Presenting With Venous Thromboembolism, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.