Differences in Severity and Outcomes Between Hypertriglyceridemia and Alcohol-Induced Pancreatitis.

IF 3.9 2区医学 Q1 CLINICAL NEUROLOGY Neurosurgery Pub Date : 2016-02-01 DOI:10.4103/1947-2714.177307

Hemant Goyal, Betsy Smith, Chelsey Bayer, Carla Rutherford, Danielle Shelnut

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Abstract

Background: Alcohol and hypertriglyceridemia (HTG) are among the most common causes of acute pancreatitis (AP) after gallstones. However, differences in severity at the time of presentation and outcomes have not been well-studied.

Objective: The aim of this study is to assess the differences between severity at presentation and outcomes of AP of hypertriglyceridemic and alcoholic origins.

Materials and methods: A retrospective review of 177 patients who were discharged with diagnosis of AP was performed. Severity at presentation was identified by the presence of systemic inflammatory response syndrome, bedside index for severity in AP (BISAP) score, and Balthazar index. Outcomes were measured by the length of stay, intensive care unit care, surgical intervention, and mortality.

Results: We found 147 patients with alcoholic pancreatitis and 30 patients with hypertriglyceridemic pancreatitis. A larger percentage of hypertriglyceridemic pancreatitis patients (23.33%) had a BISAP score of ≥2 compared to the alcoholic group (12.24%). Only 32.65% of the patients with alcoholic pancreatitis but 60% of the patients with hypertriglyceridemic pancreatitis had the presence of systemic inflammatory response syndrome (SIRS) at admission (P = 0.0067). There were 73.34% hypertriglyceridemic pancreatits patients and only 40.28% alcoholic pancreatitis patients with Balthazar index C or greater, suggesting a higher disease burden at admission for hypertriglyceridemic pancreatitis patients (P = 0.0047). There was a statistically significant difference in the relative number of hypertriglyceridemic and alcoholic pancreatitis patients receiving intensive care (P = 0.00030) and in receiving surgical interventions related to pancreatitis (P = 0.016).

Conclusion: Our study found that patients with hypertriglyceridemic pancreatitis have a greater severity of disease and they experience less favorable outcomes than patients with alcoholic pancreatitis.

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高甘油三酯血症与酒精诱发的胰腺炎在严重程度和结果上的差异。

背景：酒精和高甘油三酯血症（HTG）是胆结石后急性胰腺炎（AP）最常见的病因之一。然而，对发病时严重程度和预后的差异尚未进行深入研究：本研究旨在评估高甘油三酯性急性胰腺炎和酒精性急性胰腺炎发病时的严重程度和预后之间的差异：对177名出院诊断为AP的患者进行了回顾性研究。发病时的严重程度通过是否存在全身炎症反应综合征、AP 严重程度床旁指数（BISAP）评分和巴尔塔扎指数来确定。结果以住院时间、重症监护室护理、手术干预和死亡率来衡量：我们发现了 147 名酒精性胰腺炎患者和 30 名高甘油三酯性胰腺炎患者。与酒精性胰腺炎组（12.24%）相比，高甘油三酯性胰腺炎患者中 BISAP 评分≥2 的比例更高（23.33%）。只有 32.65% 的酒精性胰腺炎患者和 60% 的高甘油三酯性胰腺炎患者在入院时出现了全身炎症反应综合征（SIRS）（P = 0.0067）。73.34%的高甘油三酯性胰腺炎患者和40.28%的酒精性胰腺炎患者的巴尔塔扎指数大于或等于C，这表明高甘油三酯性胰腺炎患者入院时疾病负担较重（P = 0.0047）。高甘油三酯性胰腺炎患者和酒精性胰腺炎患者在接受重症监护（P = 0.00030）和接受与胰腺炎相关的外科干预（P = 0.016）的相对人数上存在统计学差异：我们的研究发现，与酒精性胰腺炎患者相比，高甘油三酯性胰腺炎患者的病情更严重，预后更差。

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来源期刊

Neurosurgery 医学-临床神经学

CiteScore

8.20

自引率

6.20%

发文量

898

审稿时长

2-4 weeks

期刊介绍： Neurosurgery, the official journal of the Congress of Neurological Surgeons, publishes research on clinical and experimental neurosurgery covering the very latest developments in science, technology, and medicine. For professionals aware of the rapid pace of developments in the field, this journal is nothing short of indispensable as the most complete window on the contemporary field of neurosurgery. Neurosurgery is the fastest-growing journal in the field, with a worldwide reputation for reliable coverage delivered with a fresh and dynamic outlook.