CLD Portends Worse Outcomes in Acute Pancreatitis

TOPLINE: 

In patients with acute pancreatitis, concomitant chronic liver disease (CLD) more than doubles the odds of in-hospital mortality and leads to higher rates of systemic and local complications.

METHODOLOGY:

• Given the overlapping risk factors and potential for coexistence, it is important to address the gap in current knowledge regarding the relationship between acute pancreatitis and CLD.
• Researchers conducted a systematic review and meta-analysis of 36 studies focusing on adult patients with acute pancreatitis and CLD, which compared results with control patients without CLD.
• Among the included studies, 12 reported on cirrhosis and 24 on steatotic liver disease, with seven reporting specifically on nonalcoholic fatty liver disease and one on metabolic-associated fatty liver disease.
• The primary outcome was mortality, and the secondary outcomes were the severity of acute pancreatitis, local or systemic complications, and length of hospital stay.

TAKEAWAY:

• CLD increased the odds of in-hospital mortality by 2.53-fold in patients with acute pancreatitis (P = .01).
• CLD was associated with significantly higher odds of renal failure (odds ratio [OR], 1.92; P = .01) and respiratory failure (OR, 1.99; P = .033).
• CLD increased the odds of single organ failure by 2.59-fold (P < .01) and multiple organ dysfunction syndrome by 1.37-fold (P = .028). It also increased the likelihood of developing systemic inflammatory response syndrome by 1.95-fold (P = .042).
• The risk for local complications, including acute necrotic collections (OR, 2.53; P = .001), pancreatic fluid collection (OR, 2.39; P = .002), and pancreatic pseudocysts (OR, 1.53; P = .039), was higher in patients with CLD than those without.

IN PRACTICE:

“Patients with concomitant [acute pancreatitis] and CLD require more attention and rigorous monitoring during hospitalization as they are at higher risk of more severe forms of diseases and of both local and systemic complications,” the authors wrote. 

SOURCE:

The study, led by Jakub Hoferica, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary, was published online in Scientific Reports. 

LIMITATIONS:

The reliance on retrospective and cross-sectional data may have limited the level of evidence. The nature of the datasets limited more detailed subgrouping according to the etiology or stage of liver fibrosis. The greater number of studies with moderate or high risk for bias may affect the reliability of the findings. 

DISCLOSURES:

The study was supported by an open access funding provided by Semmelweis University. The authors declared no conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.