Clinical Outcomes of Acute Pancreatitis in Patients with Cirrhosis According to Liver Disease Severity Scores

• Published in: Digestive diseases and sciences Vol. 66; no. 8; pp. 2795 - 2804
• Main Authors: Simons-Linares, C. Roberto, Abushamma, Suha, Romero-Marrero, Carlos, Bhatt, Amit, Lopez, Rocio, Jang, Sunguk, Vargo, John, Stevens, Tyler, O’Shea, Robert, Carey, William, Chahal, Prabhleen
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.08.2021; Springer; Springer Nature B.V
• Subjects: Alcohol; Biochemistry; Biopsy; Body mass index; Care and treatment; Children; Clinical outcomes; Diseases; Etiology; Gastroenterology; Gender; Hepatitis; Hepatology; Hospitals; Intensive care; Liver cirrhosis; Liver diseases; Medicine; Medicine & Public Health; Morbidity; Mortality; Oncology; Original Article; Pancreatitis; Patient outcomes; Patients; Respiratory failure; Transplant Surgery; Variables; Cirrhosis outcomes; Acute pancreatitis; Liver cirrhosis pancreatitis; Severe pancreatitis
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-020-06575-x

Background Literature on acute pancreatitis (AP) outcomes in patients with cirrhosis is limited. We aim to investigate the mortality and morbidity of AP in patients with cirrhosis. Methods We conducted a retrospective cohort study, and propensity score matching was done to match cirrhotic with non-cirrhotic patients on a 1:2 basis. Outcomes included inpatient mortality, organs failure, systemic inflammatory response syndrome, and length of hospital stay. We performed subgroup analysis of cirrhotics according to Child–Pugh and MELD scores. Multivariable logistic regression models were tested. Results From 819 AP patients, cirrhosis prevalence was 4.9% (40). There was no significant difference between cirrhotics and non-cirrhotics for inpatient mortality (7.5% vs. 1.3%, p  = 0.1), severe AP (17.5% vs. 7.5%), shock (7.9% vs. 3%), respiratory failure (10% vs. 3.8%), need for intensive care unit (15% vs. 6.3%), systemic inflammatory response syndrome (SIRS) on admission (22.5% vs. 32.5%), and SIRS on day 2 (25% vs. 15%). Cirrhotics had similar rates of pancreatic necrosis, ileus, BISAP score, Marshall score, admission hematocrit, BUN, and hospital length of stay. Finally, cirrhotics who had severe AP, required ICU, and/or die in-hospital appeared to have more severe liver diseases (Child-C, higher MELD score > 17) and had lower AP severity scores (BISAP < 3, Marshall scores < 2). Conclusion In our study, cirrhotics hospitalized with AP had similar morbidity and mortality when compared to non-cirrhotics.