A clinical risk score for early thrombosis detection in acute and chronic pancreatitis: insights from a large cohort study.

@article{vielhauer2026clinical,
  title = {{A clinical risk score for early thrombosis detection in acute and chronic pancreatitis: insights from a large cohort study.}},
  author = {Jakob Vielhauer and Anna Hausdorf and Marlies Gwendolyn Vornhuelz and Simon Sirtl and Inga Hubrecht and Rainer Kaiser and Lennart Kreutz and Liva Rudroff and Ignazio Piseddu and Georg Beyer and Steffen Massberg and Julia Mayerle and Hans Christian Stubbe},
  journal = {EGastroenterology},
  year = {2026},
  month = oct,
  doi = {10.1136/egastro-2026-100439},
  url = {https://europepmc.org/article/MED/42921121},
  note = {CC BY-NC},
}

TY  - JOUR
TI  - A clinical risk score for early thrombosis detection in acute and chronic pancreatitis: insights from a large cohort study.
AU  - Jakob Vielhauer
AU  - Anna Hausdorf
AU  - Marlies Gwendolyn Vornhuelz
AU  - Simon Sirtl
AU  - Inga Hubrecht
AU  - Rainer Kaiser
AU  - Lennart Kreutz
AU  - Liva Rudroff
AU  - Ignazio Piseddu
AU  - Georg Beyer
AU  - Steffen Massberg
AU  - Julia Mayerle
AU  - Hans Christian Stubbe
PY  - 2026
DA  - 2026/10/15
JO  - EGastroenterology
DO  - 10.1136/egastro-2026-100439
UR  - https://europepmc.org/article/MED/42921121
AB  - 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.Results  Among 647 patients, 114 (17.6%) developed VTE, with similar incidence rates in acute (59, 16.2%) and chronic pancreatitis (55, 19.5%). Deep vein thrombosis (5.9%) and pulmonary embolism (4.2%) were the most frequent events. Patients with VTE experienced significantly worse clinical courses, including longer hospitalisation (15 vs 7 days, p<0.001), higher rates of severe pancreatitis and increased need for advanced analgesia. Thrombosis was associated with lower diastolic blood pressure, reduced oxygen saturation, tachycardia, older age and lower body mass index at admission as well as higher rates of systemic and local complications. Mortality was markedly higher in patients with VTE (8.8% vs 2.1%, p=0.029). A six-item admission-only risk score (0-8 points) demonstrated good discrimination (AUC 0.71) and effectively stratified patients into low-risk (7.6%), intermediate-risk (22.0%) and high-risk groups (38.5%).Conclusion  VTE is common in pancreatitis and strongly associated with adverse outcomes. A simple admission-time clinical score reliably identifies high-risk patients and may support earlier recognition, targeted diagnostic evaluation and risk stratification.
SN  - 2766-0125
SN  - 2976-7296
ER  -