Does Etiology of Pancreatitis Matter? Differences in Outcomes among Patients with Post-Endoscopic Retrograde Cholangiopancreatography, Acute Biliary, and Alcoholic Pancreatitis

Ayesha Kamal, Venkata S. Akshintala, Muhammad M. Kamal, Mohammad El Zein, Sepideh Besharati, Vivek Kumbhari, Saowanee Ngamruengphong, Eun Shin, Vikesh Singh, Anthony N Kalloo, Mouen Khashab

Research output: Contribution to journalArticle

Abstract

Objectives We compared outcomes of acute alcoholic pancreatitis (AAP), acute biliary pancreatitis (ABP), and post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Methods This was a retrospective cohort study conducted at a tertiary care center between June 2007 and June 2012. Results A total of 300 (68%) patients were diagnosed with AAP, 88 (20%) with ABP, and 55 (12%) with PEP. Longer length of hospital stay (LOHS) was more common in ABP (23%) as compared with AAP (10%) and PEP (7%, P = 0.025). Pseudocyst (P = 0.048), organ failure (OF) (P = 0.01), need for interventions (P ≤ 0.001), and mortality (P = 0.002) occurred more in ABP as compared with other groups. Systemic inflammatory response syndrome was associated with LOHS of more than 10 days (P = 0.01) and multi-OF (P = 0.05). Chronic pancreatitis was associated more with pseudocyst (P < 0.001) and mortality (P = 0.03). Serum urea nitrogen of greater than 25 g/dL predicted LOHS of more than 10 days (P = 0.02), OF (P < 0.001), multi-OF (P < 0.001), and persistent OF (P < 0.001). Conclusions Acute biliary pancreatitis is a more severe disease compared with PEP and AAP. Chronic pancreatitis, systemic inflammatory response syndrome, and high serum urea nitrogen are important predictors of morbidity.

Original languageEnglish (US)
Pages (from-to)574-578
Number of pages5
JournalPancreas
Volume48
Issue number4
DOIs
StatePublished - Apr 1 2019

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Alcoholic Pancreatitis
Endoscopic Retrograde Cholangiopancreatography
Pancreatitis
Length of Stay
Systemic Inflammatory Response Syndrome
Chronic Pancreatitis
Urea
Nitrogen
Mortality
Serum
Tertiary Care Centers
Cohort Studies
Retrospective Studies
Morbidity
Peptamen

Keywords

  • alcoholic pancreatitis
  • biliary pancreatitis
  • ERCP
  • organ failure
  • persistent

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

@article{938a9f7a63f943578d43407d77e420a6,
title = "Does Etiology of Pancreatitis Matter? Differences in Outcomes among Patients with Post-Endoscopic Retrograde Cholangiopancreatography, Acute Biliary, and Alcoholic Pancreatitis",
abstract = "Objectives We compared outcomes of acute alcoholic pancreatitis (AAP), acute biliary pancreatitis (ABP), and post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Methods This was a retrospective cohort study conducted at a tertiary care center between June 2007 and June 2012. Results A total of 300 (68{\%}) patients were diagnosed with AAP, 88 (20{\%}) with ABP, and 55 (12{\%}) with PEP. Longer length of hospital stay (LOHS) was more common in ABP (23{\%}) as compared with AAP (10{\%}) and PEP (7{\%}, P = 0.025). Pseudocyst (P = 0.048), organ failure (OF) (P = 0.01), need for interventions (P ≤ 0.001), and mortality (P = 0.002) occurred more in ABP as compared with other groups. Systemic inflammatory response syndrome was associated with LOHS of more than 10 days (P = 0.01) and multi-OF (P = 0.05). Chronic pancreatitis was associated more with pseudocyst (P < 0.001) and mortality (P = 0.03). Serum urea nitrogen of greater than 25 g/dL predicted LOHS of more than 10 days (P = 0.02), OF (P < 0.001), multi-OF (P < 0.001), and persistent OF (P < 0.001). Conclusions Acute biliary pancreatitis is a more severe disease compared with PEP and AAP. Chronic pancreatitis, systemic inflammatory response syndrome, and high serum urea nitrogen are important predictors of morbidity.",
keywords = "alcoholic pancreatitis, biliary pancreatitis, ERCP, organ failure, persistent",
author = "Ayesha Kamal and Akshintala, {Venkata S.} and Kamal, {Muhammad M.} and {El Zein}, Mohammad and Sepideh Besharati and Vivek Kumbhari and Saowanee Ngamruengphong and Eun Shin and Vikesh Singh and Kalloo, {Anthony N} and Mouen Khashab",
year = "2019",
month = "4",
day = "1",
doi = "10.1097/MPA.0000000000001283",
language = "English (US)",
volume = "48",
pages = "574--578",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Does Etiology of Pancreatitis Matter? Differences in Outcomes among Patients with Post-Endoscopic Retrograde Cholangiopancreatography, Acute Biliary, and Alcoholic Pancreatitis

AU - Kamal, Ayesha

AU - Akshintala, Venkata S.

AU - Kamal, Muhammad M.

AU - El Zein, Mohammad

AU - Besharati, Sepideh

AU - Kumbhari, Vivek

AU - Ngamruengphong, Saowanee

AU - Shin, Eun

AU - Singh, Vikesh

AU - Kalloo, Anthony N

AU - Khashab, Mouen

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Objectives We compared outcomes of acute alcoholic pancreatitis (AAP), acute biliary pancreatitis (ABP), and post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Methods This was a retrospective cohort study conducted at a tertiary care center between June 2007 and June 2012. Results A total of 300 (68%) patients were diagnosed with AAP, 88 (20%) with ABP, and 55 (12%) with PEP. Longer length of hospital stay (LOHS) was more common in ABP (23%) as compared with AAP (10%) and PEP (7%, P = 0.025). Pseudocyst (P = 0.048), organ failure (OF) (P = 0.01), need for interventions (P ≤ 0.001), and mortality (P = 0.002) occurred more in ABP as compared with other groups. Systemic inflammatory response syndrome was associated with LOHS of more than 10 days (P = 0.01) and multi-OF (P = 0.05). Chronic pancreatitis was associated more with pseudocyst (P < 0.001) and mortality (P = 0.03). Serum urea nitrogen of greater than 25 g/dL predicted LOHS of more than 10 days (P = 0.02), OF (P < 0.001), multi-OF (P < 0.001), and persistent OF (P < 0.001). Conclusions Acute biliary pancreatitis is a more severe disease compared with PEP and AAP. Chronic pancreatitis, systemic inflammatory response syndrome, and high serum urea nitrogen are important predictors of morbidity.

AB - Objectives We compared outcomes of acute alcoholic pancreatitis (AAP), acute biliary pancreatitis (ABP), and post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Methods This was a retrospective cohort study conducted at a tertiary care center between June 2007 and June 2012. Results A total of 300 (68%) patients were diagnosed with AAP, 88 (20%) with ABP, and 55 (12%) with PEP. Longer length of hospital stay (LOHS) was more common in ABP (23%) as compared with AAP (10%) and PEP (7%, P = 0.025). Pseudocyst (P = 0.048), organ failure (OF) (P = 0.01), need for interventions (P ≤ 0.001), and mortality (P = 0.002) occurred more in ABP as compared with other groups. Systemic inflammatory response syndrome was associated with LOHS of more than 10 days (P = 0.01) and multi-OF (P = 0.05). Chronic pancreatitis was associated more with pseudocyst (P < 0.001) and mortality (P = 0.03). Serum urea nitrogen of greater than 25 g/dL predicted LOHS of more than 10 days (P = 0.02), OF (P < 0.001), multi-OF (P < 0.001), and persistent OF (P < 0.001). Conclusions Acute biliary pancreatitis is a more severe disease compared with PEP and AAP. Chronic pancreatitis, systemic inflammatory response syndrome, and high serum urea nitrogen are important predictors of morbidity.

KW - alcoholic pancreatitis

KW - biliary pancreatitis

KW - ERCP

KW - organ failure

KW - persistent

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U2 - 10.1097/MPA.0000000000001283

DO - 10.1097/MPA.0000000000001283

M3 - Article

C2 - 30946237

AN - SCOPUS:85064204725

VL - 48

SP - 574

EP - 578

JO - Pancreas

JF - Pancreas

SN - 0885-3177

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