Portal vein thrombosis in gastrointestinal cancers: Insights into prevalence and prognosis—A nationwide inpatient analysis 2018-2020.

e16382 Background: The relation between cancer and thrombotic events has been well established over the past decade. Cancer is a prothrombotic state and thrombosis is the second most common cause of death in cancer. While portal vein thrombosis (PVT) has been extensively studied in individuals with Hepatocellular Carcinoma (HCC), its significance in other Gastrointestinal (GI) cancers is often overlooked. This study aims to investigate the prevalence and prognostic impact of PVT across various GI cancers. Methods: A retrospective analysis was performed on the National Inpatient Sample database (2018-2020) and the ICD-10 codes to identify the patients > 18 years old with primary diagnosis of GI cancers (pancreatic, HCC, gastric, small intestinalSI, colorectal). Prevalence of PVT in individual GI cancers and effect of PVT on mortality, length of stay and Hospital cost utilization was studied. Multivariable regression analyses were performed adjusting for demographics, hospital-level characteristics, and relevant comorbidities. These included Age, Sex, Race, obesity, Smoking, Hypertension, Diabetes, CKD, liver disease, CHF, CAD, Hypothyroidism. Results: Our study analyzed data from 2,313,888 individuals with GI cancers, Including HCC, Gastric cancer, SI cancer, colorectal and pancreatic cancer, The incidence of PVT varied across cancer types, with 12.9% in pancreatic cancer, 0.74% in HCC, 0.99% in gastric cancer, 0.47% in colorectal cancer, and 3.6% in pancreatic cancer. Multivariate regression analysis, adjusting for confounders, revealed a significant association between PVT and increased mortality in various GI cancers. Specifically, the odds ratio (OR) for mortality in pancreatic cancer was 1.31 (p < 0.001), in HCC was 1.39 (p < 0.001), in gastric cancer was 1.88 (p < 0.001), and in colorectal cancer was 2.10 (p < 0.001). However, the incidence of mortality in SI cancer did not yield a significant result OR 1.42 p- value 0.369 Table 1. Additionally, Our findings revealed an increase in length of stay and total healthcare resource utilization across all GI cancers for individuals with PVT compared to without PVT. Conclusions: There is a statistically significant effect of symptomatic and asymptomatic PVT on mortality in various other GI cancers in addition to HCC, which has been established and studied widely. Further prospective studies are needed to study the effect of diagnosing PVT earlier in the disease to predict mortality and other major complications in GI cancers.Table: see text