Splanchnic vein thrombosis (2003−2022): a Swiss nationwide epidemiological study
Silvia Cardi a),b); Simon Wolf a),c); Riccardo M. Fumagalli a),c); Corrado Lodigiani b),d); Fabian Rössler e); Alice Trinchero f); Luca Valerio g),h); Walter Ageno i); Nils Kucher a); Stefano Barco a),c),g).
a) Department of Angiology, University Hospital Zurich, Zurich, Switzerland
b) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
c) University of Zurich, Zurich, Switzerland
d) Center for Thrombosis and Hemorrhagic Diseases, Humanitas Clinical and Research Hospital, Rozzano, Milano, Italy
e) Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland
f) Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
g) Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
h) Department of Cardiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
i) Department of Medicine, Ospedale Regionale di Bellinzona, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
Abstract
Background
Splanchnic vein thrombosis (SVT) is a rare form of venous thromboembolism with limited epidemiological data. This study aims to provide a detailed overview in Switzerland using administrative records.
Methods
We analysed nationwide patient-level data on SVT-related hospitalizations, including portal, splenic, and hepatic (Budd-Chiari syndrome) vein thrombosis from 2003 to 2022. We assessed trends in crude and age-standardized incidence rates, proportion of SVT-related hospitalizations, readmission rates as well as gender differences, comorbidities, clinical features, and in-hospital outcomes. Multivariable logistic regression was used to identify predictors of in-hospital death.
Results
SVT was recorded in 17,966 hospitalizations (35 % women) involving 13,689 patients. Portal vein thrombosis was the most frequent manifestation, followed by splenic, hepatic and multisegmental thrombosis. Age-standardized incidence rate increased from 0.4 (95 % CI: 0.3–0.4) per 10,000 general population in 2003 to 1.5 (95 % CI: 1.4–1.6) in 2022, with rising proportions of SVT-related hospitalizations and readmission rates. Case fatality rate remained steady at 13 % and was highest for portal vein thrombosis. For most SVT subtypes, incidence rate was higher in males and case fatality rate in females. Predictors of in-hospital death included liver failure, intestinal infectious diseases, cancer. Common comorbidities included non-neoplastic abdominal diseases (14,010; 78 %), cardiovascular diseases (11,214; 62 %), and cancer (8510; 47 %). Diagnostic or therapeutic procedures involved 56 % of cases, intensive care stay 19 %, and median length of stay was 11 days (Q1-Q3 5–19).
Conclusion
Despite its rarity, SVT is characterized by substantial morbidity and in-hospital mortality. Further research is needed to validate these findings and improve patient management.