Baseline severity and etiology parameters in acute pancreatitis A descriptive cross-sectional analysis

Abstract

Rapidly identifying acute pancreatitis (AP) patients at higher risk of developing severe AP (SAP) can help clinicians better direct medical treatment and management. Therefore, we examined clinical parameters and laboratory markers in patients with different etiologies and severities of AP. Demographic, clinical characteristics, and laboratory data were collected from electronic medical records of adult patients with AP and admitted to 1 healthcare system between 2015 and 2021. AP severity was determined using the revised Atlanta classification. The association between biomarkers and outcomes was assessed using exploratory data analyses. Patients with SAP were older than those with mild AP (58.3 (20.2) vs 48.1 (17.5) years, P = .002). Acute biliary pancreatitis predominantly affected women (66%) and Hispanic individuals (51%). Acute alcoholic pancreatitis predominantly affected men (72%) and Black individuals (53%). For patients with acute biliary pancreatitis and pancreatitis of other etiologies, creatinine was the most significant predictor of pancreatitis severity. Patients with hypertriglyceridemia-associated AP were younger (mean (SD): 41.1 (11.9) years, P < .001). Distinct clinical features and indicators are indicative of mild AP and SAP. Etiology-specific patterns can aid in identifying individuals at high risk of SAP. Abbreviations: AAP = acute alcoholic pancreatitis, ABP = acute biliary pancreatitis, ALBI = albumin–bilirubin, AP = acute pancreatitis, APFC = acute pancreatic fluid collections, BISAP = bedside index for severity in acute pancreatitis, BMI = body mass index, Cr = creatinine, CRP = C-reactive protein, ED = emergency department, EDA = exploratory data analysis, HAPS = harmless acute pancreatitis score, HCT = hematocrit, HTG = hypertriglyceridemia, MAP = mild acute pancreatitis, MSAP = moderately severe acute pancreatitis, NLR = neutrophil to lymphocyte ratio, PCT = procalcitonin, PLR = platelet-to-lymphocyte ratio, SII = systemic immune-inflammation index, SIRS = systemic inflammatory response system, TOF = transient organ failure, WBC = white blood cell.