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Association Between Portal Vein Thrombosis and Pouchitis in Patients with Ulcerative Colitis
Background Pouchitis is the most common long-term complication in patients requiring colectomy ileal pouch-anal anastomosis with medically refractory ulcerative colitis or colitis-associated neoplasia. A previous small case series suggests associated between portal vein thrombosis (PVT) and ischemic...
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| Published in: | Digestive diseases and sciences 2022-04, Vol.67 (4), p.1303-1310 |
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| container_title | Digestive diseases and sciences |
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| creator | Syed, Aslam Seoud, Talal Carleton, Neil M. Thakkar, Shyam Kiran, Ravi P. Shen, Bo |
| description | Background
Pouchitis is the most common long-term complication in patients requiring colectomy ileal pouch-anal anastomosis with medically refractory ulcerative colitis or colitis-associated neoplasia. A previous small case series suggests associated between portal vein thrombosis (PVT) and ischemic pouchitis.
Aim
To evaluate the association between PVT and other demographic and clinical factors and pouchitis.
Methods
We used Explorys Inc., a population-based database, to search medical records between 1999 and 2020 with SNOMED-CT code criteria for “construction of pouch” and “ileal pouchitis.” Patients with pouchitis were compared to those with previous pouch construction without pouchitis. Factors associated with pouchitis identified with univariable analysis were introduced into a multivariable model. A post hoc analysis further stratified demographical findings of the association between PVT and pouchitis.
Results
We identified 7900 patients with ileal pouchitis (7.5%) and 97,510 with pouch construction without pouchitis. In multivariate binary logistic regression, adjusted odds ratio (aOR) for the risk of pouchitis in patients with PVT was 10.78 (95% confidence interval [CI] 7.04–16.49,
P
|
| doi_str_mv | 10.1007/s10620-021-06969-5 |
| format | article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2522398147</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A706398798</galeid><sourcerecordid>A706398798</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-8a32af20060806f87dd3854ad1aec38e0460f15646f90222fc4a754956f76d9f3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi0EokvhD3BAkbhwSTt24q_jsuJLqtQeWk5IluuMu64Su9gJFf8eL1taUSHkgz0zzzse-yXkNYUjCiCPCwXBoAVGWxBa6JY_ISvKZdcyLtRTsgIq6plScUBelHINAFpS8ZwcdJ3uleRqRb6tS0ku2Dmk2LzH-RYxNmcpz3ZsvmKIzfk2p-kylVAaG4daWtw2zDWqtbMqwziX5jbM2-ZidJhr5gc2mzTumJfkmbdjwVd3-yG5-PjhfPO5PTn99GWzPmld37O5VbZj1jMAAQqEV3IYOsV7O1CLrlMIvQBPueiF18AY8663kveaCy_FoH13SN7t-97k9H3BMpspFIfjaCOmpRjGGeu0or2s6NtH6HVacqzTGVYvqP_CmH6gruyIJkSf5mzdrqlZS6iUklpV6ugfVF0DTsGliD7U_F8Cthe4nErJ6M1NDpPNPw0Fs7PU7C011VLz21LDq-jN3cTL5YTDveSPhxXo9kCppXiF-eFJ_2n7C046qYo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2646394229</pqid></control><display><type>article</type><title>Association Between Portal Vein Thrombosis and Pouchitis in Patients with Ulcerative Colitis</title><source>Springer Nature</source><creator>Syed, Aslam ; Seoud, Talal ; Carleton, Neil M. ; Thakkar, Shyam ; Kiran, Ravi P. ; Shen, Bo</creator><creatorcontrib>Syed, Aslam ; Seoud, Talal ; Carleton, Neil M. ; Thakkar, Shyam ; Kiran, Ravi P. ; Shen, Bo</creatorcontrib><description>Background
Pouchitis is the most common long-term complication in patients requiring colectomy ileal pouch-anal anastomosis with medically refractory ulcerative colitis or colitis-associated neoplasia. A previous small case series suggests associated between portal vein thrombosis (PVT) and ischemic pouchitis.
Aim
To evaluate the association between PVT and other demographic and clinical factors and pouchitis.
Methods
We used Explorys Inc., a population-based database, to search medical records between 1999 and 2020 with SNOMED-CT code criteria for “construction of pouch” and “ileal pouchitis.” Patients with pouchitis were compared to those with previous pouch construction without pouchitis. Factors associated with pouchitis identified with univariable analysis were introduced into a multivariable model. A post hoc analysis further stratified demographical findings of the association between PVT and pouchitis.
Results
We identified 7900 patients with ileal pouchitis (7.5%) and 97,510 with pouch construction without pouchitis. In multivariate binary logistic regression, adjusted odds ratio (aOR) for the risk of pouchitis in patients with PVT was 10.78 (95% confidence interval [CI] 7.04–16.49,
P
< 0.001). Other significant factors associated with pouchitis included male gender (aOR 1.11, 95% CI 1.02–1.21,
P
= 0.018), deep vein thrombosis (aOR 1.46, 95% CI 1.23–1.72,
P
< 0.001), and the use of non-steroidal anti-inflammatory drugs (aOR 1.37, 95% CI 1.28–1.45,
P
< 0.001). Smoking was a protective factor (aOR 0.30, 95% CI 0.33–0.36,
P
< 0.001). Further sub-analysis showed a higher prevalence of younger patients with PVT and pouchitis.
Conclusions
We report PVT as an independent risk factor associated with pouchitis. Our findings support that PVT is a potentially manageable perioperative complication, and intervention may reduce the risk of pouchitis.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-021-06969-5</identifier><identifier>PMID: 33948758</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Antibiotics ; Biochemistry ; Blood clot ; Care and treatment ; Colitis, Ulcerative - complications ; Colitis, Ulcerative - surgery ; Colonic Pouches - adverse effects ; Comparative analysis ; Complications and side effects ; Construction ; Gastroenterology ; Gender ; Hepatology ; Humans ; Inflammatory bowel disease ; Male ; Medical colleges ; Medical records ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Oncology ; Original Article ; Patients ; Population ; Portal Vein - surgery ; Postoperative Complications - etiology ; Pouchitis - epidemiology ; Pouchitis - etiology ; Proctocolectomy, Restorative - adverse effects ; Risk factors ; Statistical analysis ; Thrombosis ; Transplant Surgery ; Ulcerative colitis ; Venous Thrombosis - complications ; Venous Thrombosis - etiology ; White people</subject><ispartof>Digestive diseases and sciences, 2022-04, Vol.67 (4), p.1303-1310</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><rights>COPYRIGHT 2022 Springer</rights><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-8a32af20060806f87dd3854ad1aec38e0460f15646f90222fc4a754956f76d9f3</citedby><cites>FETCH-LOGICAL-c442t-8a32af20060806f87dd3854ad1aec38e0460f15646f90222fc4a754956f76d9f3</cites><orcidid>0000-0002-7229-4840</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33948758$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Syed, Aslam</creatorcontrib><creatorcontrib>Seoud, Talal</creatorcontrib><creatorcontrib>Carleton, Neil M.</creatorcontrib><creatorcontrib>Thakkar, Shyam</creatorcontrib><creatorcontrib>Kiran, Ravi P.</creatorcontrib><creatorcontrib>Shen, Bo</creatorcontrib><title>Association Between Portal Vein Thrombosis and Pouchitis in Patients with Ulcerative Colitis</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>Background
Pouchitis is the most common long-term complication in patients requiring colectomy ileal pouch-anal anastomosis with medically refractory ulcerative colitis or colitis-associated neoplasia. A previous small case series suggests associated between portal vein thrombosis (PVT) and ischemic pouchitis.
Aim
To evaluate the association between PVT and other demographic and clinical factors and pouchitis.
Methods
We used Explorys Inc., a population-based database, to search medical records between 1999 and 2020 with SNOMED-CT code criteria for “construction of pouch” and “ileal pouchitis.” Patients with pouchitis were compared to those with previous pouch construction without pouchitis. Factors associated with pouchitis identified with univariable analysis were introduced into a multivariable model. A post hoc analysis further stratified demographical findings of the association between PVT and pouchitis.
Results
We identified 7900 patients with ileal pouchitis (7.5%) and 97,510 with pouch construction without pouchitis. In multivariate binary logistic regression, adjusted odds ratio (aOR) for the risk of pouchitis in patients with PVT was 10.78 (95% confidence interval [CI] 7.04–16.49,
P
< 0.001). Other significant factors associated with pouchitis included male gender (aOR 1.11, 95% CI 1.02–1.21,
P
= 0.018), deep vein thrombosis (aOR 1.46, 95% CI 1.23–1.72,
P
< 0.001), and the use of non-steroidal anti-inflammatory drugs (aOR 1.37, 95% CI 1.28–1.45,
P
< 0.001). Smoking was a protective factor (aOR 0.30, 95% CI 0.33–0.36,
P
< 0.001). Further sub-analysis showed a higher prevalence of younger patients with PVT and pouchitis.
Conclusions
We report PVT as an independent risk factor associated with pouchitis. Our findings support that PVT is a potentially manageable perioperative complication, and intervention may reduce the risk of pouchitis.</description><subject>Antibiotics</subject><subject>Biochemistry</subject><subject>Blood clot</subject><subject>Care and treatment</subject><subject>Colitis, Ulcerative - complications</subject><subject>Colitis, Ulcerative - surgery</subject><subject>Colonic Pouches - adverse effects</subject><subject>Comparative analysis</subject><subject>Complications and side effects</subject><subject>Construction</subject><subject>Gastroenterology</subject><subject>Gender</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Inflammatory bowel disease</subject><subject>Male</subject><subject>Medical colleges</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Population</subject><subject>Portal Vein - surgery</subject><subject>Postoperative Complications - etiology</subject><subject>Pouchitis - epidemiology</subject><subject>Pouchitis - etiology</subject><subject>Proctocolectomy, Restorative - adverse effects</subject><subject>Risk factors</subject><subject>Statistical analysis</subject><subject>Thrombosis</subject><subject>Transplant Surgery</subject><subject>Ulcerative colitis</subject><subject>Venous Thrombosis - complications</subject><subject>Venous Thrombosis - etiology</subject><subject>White people</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kU1v1DAQhi0EokvhD3BAkbhwSTt24q_jsuJLqtQeWk5IluuMu64Su9gJFf8eL1taUSHkgz0zzzse-yXkNYUjCiCPCwXBoAVGWxBa6JY_ISvKZdcyLtRTsgIq6plScUBelHINAFpS8ZwcdJ3uleRqRb6tS0ku2Dmk2LzH-RYxNmcpz3ZsvmKIzfk2p-kylVAaG4daWtw2zDWqtbMqwziX5jbM2-ZidJhr5gc2mzTumJfkmbdjwVd3-yG5-PjhfPO5PTn99GWzPmld37O5VbZj1jMAAQqEV3IYOsV7O1CLrlMIvQBPueiF18AY8663kveaCy_FoH13SN7t-97k9H3BMpspFIfjaCOmpRjGGeu0or2s6NtH6HVacqzTGVYvqP_CmH6gruyIJkSf5mzdrqlZS6iUklpV6ugfVF0DTsGliD7U_F8Cthe4nErJ6M1NDpPNPw0Fs7PU7C011VLz21LDq-jN3cTL5YTDveSPhxXo9kCppXiF-eFJ_2n7C046qYo</recordid><startdate>20220401</startdate><enddate>20220401</enddate><creator>Syed, Aslam</creator><creator>Seoud, Talal</creator><creator>Carleton, Neil M.</creator><creator>Thakkar, Shyam</creator><creator>Kiran, Ravi P.</creator><creator>Shen, Bo</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7229-4840</orcidid></search><sort><creationdate>20220401</creationdate><title>Association Between Portal Vein Thrombosis and Pouchitis in Patients with Ulcerative Colitis</title><author>Syed, Aslam ; Seoud, Talal ; Carleton, Neil M. ; Thakkar, Shyam ; Kiran, Ravi P. ; Shen, Bo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-8a32af20060806f87dd3854ad1aec38e0460f15646f90222fc4a754956f76d9f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Antibiotics</topic><topic>Biochemistry</topic><topic>Blood clot</topic><topic>Care and treatment</topic><topic>Colitis, Ulcerative - complications</topic><topic>Colitis, Ulcerative - surgery</topic><topic>Colonic Pouches - adverse effects</topic><topic>Comparative analysis</topic><topic>Complications and side effects</topic><topic>Construction</topic><topic>Gastroenterology</topic><topic>Gender</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Inflammatory bowel disease</topic><topic>Male</topic><topic>Medical colleges</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Population</topic><topic>Portal Vein - surgery</topic><topic>Postoperative Complications - etiology</topic><topic>Pouchitis - epidemiology</topic><topic>Pouchitis - etiology</topic><topic>Proctocolectomy, Restorative - adverse effects</topic><topic>Risk factors</topic><topic>Statistical analysis</topic><topic>Thrombosis</topic><topic>Transplant Surgery</topic><topic>Ulcerative colitis</topic><topic>Venous Thrombosis - complications</topic><topic>Venous Thrombosis - etiology</topic><topic>White people</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Syed, Aslam</creatorcontrib><creatorcontrib>Seoud, Talal</creatorcontrib><creatorcontrib>Carleton, Neil M.</creatorcontrib><creatorcontrib>Thakkar, Shyam</creatorcontrib><creatorcontrib>Kiran, Ravi P.</creatorcontrib><creatorcontrib>Shen, Bo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing and Allied Health Journals</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Syed, Aslam</au><au>Seoud, Talal</au><au>Carleton, Neil M.</au><au>Thakkar, Shyam</au><au>Kiran, Ravi P.</au><au>Shen, Bo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between Portal Vein Thrombosis and Pouchitis in Patients with Ulcerative Colitis</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2022-04-01</date><risdate>2022</risdate><volume>67</volume><issue>4</issue><spage>1303</spage><epage>1310</epage><pages>1303-1310</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><abstract>Background
Pouchitis is the most common long-term complication in patients requiring colectomy ileal pouch-anal anastomosis with medically refractory ulcerative colitis or colitis-associated neoplasia. A previous small case series suggests associated between portal vein thrombosis (PVT) and ischemic pouchitis.
Aim
To evaluate the association between PVT and other demographic and clinical factors and pouchitis.
Methods
We used Explorys Inc., a population-based database, to search medical records between 1999 and 2020 with SNOMED-CT code criteria for “construction of pouch” and “ileal pouchitis.” Patients with pouchitis were compared to those with previous pouch construction without pouchitis. Factors associated with pouchitis identified with univariable analysis were introduced into a multivariable model. A post hoc analysis further stratified demographical findings of the association between PVT and pouchitis.
Results
We identified 7900 patients with ileal pouchitis (7.5%) and 97,510 with pouch construction without pouchitis. In multivariate binary logistic regression, adjusted odds ratio (aOR) for the risk of pouchitis in patients with PVT was 10.78 (95% confidence interval [CI] 7.04–16.49,
P
< 0.001). Other significant factors associated with pouchitis included male gender (aOR 1.11, 95% CI 1.02–1.21,
P
= 0.018), deep vein thrombosis (aOR 1.46, 95% CI 1.23–1.72,
P
< 0.001), and the use of non-steroidal anti-inflammatory drugs (aOR 1.37, 95% CI 1.28–1.45,
P
< 0.001). Smoking was a protective factor (aOR 0.30, 95% CI 0.33–0.36,
P
< 0.001). Further sub-analysis showed a higher prevalence of younger patients with PVT and pouchitis.
Conclusions
We report PVT as an independent risk factor associated with pouchitis. Our findings support that PVT is a potentially manageable perioperative complication, and intervention may reduce the risk of pouchitis.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33948758</pmid><doi>10.1007/s10620-021-06969-5</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7229-4840</orcidid></addata></record> |
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| language | eng |
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| source | Springer Nature |
| subjects | Antibiotics Biochemistry Blood clot Care and treatment Colitis, Ulcerative - complications Colitis, Ulcerative - surgery Colonic Pouches - adverse effects Comparative analysis Complications and side effects Construction Gastroenterology Gender Hepatology Humans Inflammatory bowel disease Male Medical colleges Medical records Medical research Medicine Medicine & Public Health Medicine, Experimental Oncology Original Article Patients Population Portal Vein - surgery Postoperative Complications - etiology Pouchitis - epidemiology Pouchitis - etiology Proctocolectomy, Restorative - adverse effects Risk factors Statistical analysis Thrombosis Transplant Surgery Ulcerative colitis Venous Thrombosis - complications Venous Thrombosis - etiology White people |
| title | Association Between Portal Vein Thrombosis and Pouchitis in Patients with Ulcerative Colitis |
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