Comparison of severity and clinical outcomes between hypertriglyceridemic pancreatitis and acute pancreatitis due to other causes

TLDR: Compared with AP of other causes, HTGP patients have more severe clinical course and worse clinical outcomes, and the serum TG level within 24 hours of onset may be positively correlated with the severity of HTGP.

Abstract: Objective To investigate the difference in severity and clinical outcomes between hypertriglyceridemic pancreatitis (HTGP) and acute pancreatitis (AP) of other causes, and to analyze the correlation between the serum triglyceride (TG) level <24 h after onset and the disease severity Methods Patients were selected from the AP database of the First Affiliated Hospital of Nanchang University, who were admitted between January 2005 and December 2013, aged ≥18 and ≤85 years, excluding pregnant or lactating women Severity and etiology of AP were classified according to the latest relevant guidelines The severity and clinical outcomes of HTGP patients (HTGP group) were compared with those of patients with AP of other causes (non-HTGP group) Among the HTGP patients, those admitted within 24 hours of onset were selected for comparison of serum TG levels on the first day of hospitalization day among patients with mild, moderate, and severe HTGP, and the correlation between the serum TG level and the severity was analyzed Results Altogether 3 558 AP patients were selected, of which 623 (175%) were HTGP, and 2 935 (825%)were non-HTGP patients Compared with the non-HTGP group, the HTGP group had higher incidence of pancreatic necrosis (283% vs 181%), infected pancreatic necrosis (61% vs 37%), organ failure(358% vs 291%), and persistent organ failure(244% vs 165%), with all the differences being statistically significant (all P<001) The mortality and average stay in intensive care unit were also higher in the HTGP group than in the non-HTGP group (all P<005) There were 291 patients with HTGP who were admitted to hospital within 24 hours of onset The serum TG levels <24 h after onset were (938±900) mmol/L, (1190±902) mmol/L, and (1647±1175) mmol/L in patients with mild, moderate, and severe HTGP, respectively (P<001) Spearman's correlation analysis showed a positive correlation between TG level <24 h after onset and disease severity (r=026, P<001) Conclusions Compared with AP of other causes, HTGP patients have more severe clinical course and worse clinical outcomes The serum TG level within 24 hours of onset may be positively correlated with the severity of HTGP Key words: Pancreatitis; Hypertriglyceridemia; Pancreatic necrosis; Organ failure; Prognosis