studies

HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1219A
2073
The Epidemiology and Clinical Associations of Budd-
Chiari Syndrome. A Review of 507 Admissions from the
2012 National Inpatient Sample
Jennifer Saad 1 , Shawn Shah 1 , Joseph Shatzel 1 , Harley Friedman 1 ,
Neil Volk 1 , Rolland C. Dickson 2 ; 1 Internal Medicine, Dartmouth
Hitchcock Medical Center, Lebanon, NH; 2 Gastroenterology, Dartmouth
Hitchcock Medical Center, Lebanon, NH
Background: Budd-Chiari syndrome (BCS) is a rare condition
resulting from obstruction of the hepatic venous outflow tract
and is strongly associated with hypercoagulable states. Large
series on BCS are scarce, so epidemiological data has been
derived primarily from reported case series. The aim of this
study was to evaluate the epidemiology, common clinical associations,
and mortality of patients admitted with BCS from a
large national database. Methods: Using the 2012 National
Inpatient Sample (NIS), admissions with an International Classification
of Diseases, 9 th Revision, Clinical Modification code
for BCS were extracted, and correlated with age, gender,
length of stay, mortality and commonly associated diagnoses.
Results: Of the 7,296,968 unweighted admissions in the 2012
NIS, 507 were associated with BCS (prevalence 0.007%).
BCS was more common in women (55.8%) with a mean age
of 47 years (range 0-90). The average length of stay was 10
days (range 0-125) with an in-hospital mortality of 6.5%. Of
BCS admissions, 23.08% had cirrhosis of the liver, 16.77%
had portal HTN, 8.68% had both cirrhosis of the liver and
portal HTN, 16.3% had a hepatocellular malignancy (8.3%
primary, 8.1% metastatic) and 8.9% had an acquired or inherited
thrombophilia. Overall, 37.5% of patients with BCS had
a new or previously diagnosed malignancy. Myeloproliferative
or bone marrow disorders were associated with 8.1% of
BCS admissions including polycythemia vera (3.8%), essential
thrombocytosis (1.6%), paroxysmal nocturnal hemoglobinuria
(1.4%), myelofibrosis (0.8%) and chronic myelogenous leukemia
(0.6%). 28% of admissions had an acute thrombus at an
additional anatomic site (9.9% superficial or deep veins, 8.9%
inferior vena cava, 6.1% pulmonary vein and 3.2% portal
vein). There was no significant difference in the age, mortality
or length of stay between males and females with BCS. Males
were more likely to have a primary hepatocellular malignancy
(OR 3.97, 95% CI 1.95, 8.10, p