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Observational Study
. 2023 May;11(4):383-391.
doi: 10.1002/ueg2.12390. Epub 2023 Apr 24.

Obesity and alcoholic etiology as risk factors for multisystem organ failure in acute pancreatitis: Multinational study

Peter J Lee  1 , Ali Lahooti  1   2 , Stacey Culp  1 , Andrew Boutsicaris  1 , Phillip Holovach  1 , Kayla Wozniak  1 , Ila Lahooti  1 , Pedram Paragomi  3 , Alice Hinton  4 , Ioannis Pothoulakis  5 , Rupjyoti Talukdar  6 , Rakesh Kochhar  7 , Mahesh K Goenka  8 , Aiste Gulla  9 , Jose A Gonzalez  10 , Vikesh Singh  11 , Miguel Ferreira Bogado  12 , Tyler Stevens  13 , Sorin Traian Babu  14 , Haq Nawaz  15 , Silvia Cristina Gutierrez  16 , Narcis Zarnescu  17 , Gabriele Capurso  18 , Jeffrey Easler  19 , Konstantinos Triantafyllou  20 , Mario Peláez Luna  21 , Shyam Thakkar  22 , Carlos Ocampo  23 , Enrique de-Madaria  24 , Gregory A Cote  25 , Bechien U Wu  26 , Phil A Hart  1 , Somashekar G Krishna  1 , Luis Lara  1 , Samuel Han  1 , Georgios I Papachristou  1
Affiliations
Observational Study

Obesity and alcoholic etiology as risk factors for multisystem organ failure in acute pancreatitis: Multinational study

Peter J Lee et al. United European Gastroenterol J. 2023 May.

Abstract

Background: Multisystem organ failure (MSOF) is the most important determinant of mortality in acute pancreatitis (AP). Obesity and alcoholic etiology have been examined as potential risk factors for MSOF, but prior studies have not adequately elucidated their independent effects on the risk of MSOF.

Objective: We aimed to determine the adjusted effects of body mass index (BMI) and alcoholic etiology on the risk of MSOF in subjects with AP.

Methods: A prospective observational study of 22 centers from 10 countries was conducted. Patients admitted to an APPRENTICE consortium center with AP between August 2015 and January 2018 were enrolled. Multivariable logistic regression was used to estimate the adjusted effects of BMI, etiology, and other relevant covariates on the risk of MSOF. Models were stratified by sex.

Results: Among 1544 AP subjects, there was a sex-dependent association between BMI and the risk of MSOF. Increasing BMI was associated with increased odds of MSOF in males (OR 1.10, 95% confidence interval [CI] 1.04-1.15) but not in females (OR 0.98, 95% CI 0.90-1.1). Male subjects with AP, whose BMIs were 30-34 and >35 kg/m2 , had odds ratios of 3.78 (95% CI 1.62-8.83) and 3.44 (95% CI 1.08-9.99), respectively. In females, neither higher grades of obesity nor increasing age increased the risk of MSOF. Alcoholic etiology was independently associated with increased odds of MSOF compared with non-alcohol etiologies (OR 4.17, 95% CI 2.16-8.05).

Conclusion: Patients with alcoholic etiology and obese men (but not women) are at substantially increased risk of MSOF in AP.

Keywords: acute pancreatitis; alcoholic pancreatitis; multi-system organ failure; obesity.

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Conflict of interest statement

All authors of this article declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Forest plot of odds ratios for selected variables' association with multisystem organ failure in acute pancreatitis. CCI, Charlson Comorbidity Index; CHF, congestive heart failure; CI, confidence interval; CPD, chronic pulmonary disease; Transfer, subjects who were transferred from a secondary care hospital.
FIGURE 2
FIGURE 2
Forest plots showing adjusted BMI's association with multisystem organ failure in acute pancreatitis in gender‐stratified analyses.
See this image and copyright information in PMC

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