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Clinical Outcomes in A Multi-center Cohort Involving 919 Patients with Hypertriglyceridemia-associated Acute Pancreatitis

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机构： [1]Center for Biomarker Discovery and Validation, National Infrastructures for Translational Medicine (PUMCH), Institute of Clinical Medicine, Peking Union Medical College Hospital, Beijing, China. [2]Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilong Jiang Province, China. [3]Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China. [4]Pancreatic Center, Department of Gastroenterology, Yangzhou Key Laboratory of Pancreatic Disease, Institute of Digestive Diseases, The Affiliated Hospital of Yangzhou University, Yangzhou, Jiangsu Province, China. [5]Pancreas Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China. [6]Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, Shanxi Province, China. [7]State Key Laboratory of CAD& CG, Zhejiang University, Zhejiang Province, China.

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关键词： HTG-AP pancreatitis severity risk factors prediction model scoring tool

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Hypertriglyceridemia-associated acute pancreatitis (HTG-AP) is one of the most common etiologies of acute pancreatitis (AP) worldwide. Compared to other etiologies, patients with HTG-AP may develop more severe AP, but previous studies yielded controversial conclusion due to the lack of adequate adjustment for the confounders. Therefore, this study aimed to examine the possibility and risk factors of developing severe AP in HTG-AP.Data from patients with an established diagnosis of AP were collected from January 2013 to December 2023 using a pre-designed data collection form and were gathered from five tertiary cross-regional centers of China. HTG-AP was defined as serum triglyceride (TG) levels >500 mg/dl and excluded other etiologies. The possibility and risk factors of severe AP were assessed by multivariable logistic regressions after adjusting potential confounders. A prediction model was established and validated.Between 2013 to 2023, we identified a total of 6996 patients with AP, of whom 4378 were included in the final analysis. Compared to other etiologies, patients with HTG-AP had a higher risk of developing severe AP (odds ratio [OR]: 1.897; 95% confidence interval [CI]: 1.380-2.608; p<0.001) and organ failure. HTG-AP patients showed higher possibility for developing respiratory and circulation failure but renal failure compare to other etiologies. In HTG-AP patients, risk factors for severe AP included age, fasting blood glucose, white blood cell (WBC) counts, and the presence of pleural effusion. Triglyceride level was found not significantly associated with severity in HTG-AP patients. A prediction model incorporating these risk factors demonstrated an AUC of 0.837 in the training and 0.883 in the testing set, with adequate calibration.Using a multi-center cross-regional cohort, we demonstrated that HTG-AP had a higher risk of developing severe AP and organ failure. A risk prediction model for predicting severe AP was developed and effectively stratified patients.Copyright © 2025 by The American College of Gastroenterology.

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出版当年[2025]版：

大类 | 1 区

医学

小类 | 2 区胃肠肝病学

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大类 | 1 区

医学

小类 | 2 区胃肠肝病学

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第一作者机构： [1]Center for Biomarker Discovery and Validation, National Infrastructures for Translational Medicine (PUMCH), Institute of Clinical Medicine, Peking Union Medical College Hospital, Beijing, China.

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