Association of hereditary hemochromatosis with portal vein thrombosis: A national inpatient sample (2016-2020) analysis

Abstract

Abstract Hereditary hemochromatosis is a common inherited metabolic disorder of iron metabolism with variable penetrance. Portal vein thrombosis has several well-known causes including cirrhosis, myeloproliferative neoplasm, inflammatory conditions of abdomen (acute appendicitis, acute diverticulitis, and acute pancreatitis), intra-abdominal malignancy, intra-abdominal surgery, and thrombophilia. It is unknown whether hereditary hemochromatosis is associated with portal vein thrombosis. A retrospective analysis of the NIS database from 2016 to 2020 was conducted using International Classification of Diseases (ICD-10) codes to identify hospitalizations with portal vein thrombosis. We used Fischer's exact test to compare proportions and the student's t-test to compare continuous variables. We used multivariate regression analysis to calculate the adjusted odds ratio after controlling for age, gender, primary payer, Charlson Comorbidity index, cirrhosis, myeloproliferative neoplasm, inflammatory conditions of abdomen (acute appendicitis, acute diverticulitis, and acute pancreatitis), intra-abdominal malignancy, intra-abdominal surgery, history of past thrombosis, thrombophilia, end stage renal disease, obesity, smoking, and hyperlipidemia.There were 25805 hospitalizations with primary diagnosis of portal vein thrombosis. Multivariate logistic regression showed that hereditary hemochromatosis was independently associated with portal vein thrombosis (OR = 4.7, 95% CI = 1.15 to 19.35, p-value = 0.03) along with cirrhosis, myeloproliferative neoplasm, inflammatory conditions of abdomen, intra-abdominal malignancy, history of thrombosis, history of abdominal surgery, history of thrombophilia, and end stage renal disease among other factors.