Decreased skeletal muscle density is an independent predictor of mortality in necrotizing pancreatitis- A single tertiary center experience in 507 patients

Trikudanathan, Guru; Vantanasiri, Kornpong; Faizi, Nauroze A.; Munigala, Satish; Vaněk, Petr; Schat, Robben; Freeman, Martin L.; Chauhan, Anil

doi:10.1016/j.pan.2021.05.010

Cited by 12 publications

(12 citation statements)

References 41 publications

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“…This finding was consistent with a recent large, single-institution study of 676 patients with NP [ 58 ]. One potential explanation for this may be that once a patient with AP develops NP, worst clinical outcomes are mainly explained by other risk factors (such as hemorrhage [ 59 ], colon involvement [ 60 ], abdominal free fluid [ 61 ], low skeletal muscle density [ 62 ], etc.) rather than etiology.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and risk factors of organ failure and death in necrotizing pancreatitis

Xie

Luo

et al. 2023

BMC Gastroenterol

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Background Organ failure (OF) and death are considered the most significant adverse outcomes in necrotizing pancreatitis (NP). However, there are few NP-related studies describing the clinical traits of OF and aggravated outcomes. Purpose An improved insight into the details of OF and death will be helpful to the management of NP. Thus, in our research, we addressed the risk factors of OF and death in NP patients. Methods We performed a study of 432 NP patients from May 2017 to December 2021. All patients with NP were followed up for 36 months. The primary end-points were risk factors of OF and death in NP patients. The risk factors were evaluated by logistic regression analysis. Results NP patients with OF or death patients were generally older, had a higher APACHE II score, longer hospital stay, longer ICU stay, as well as a higher incidence of severe acute pancreatitis (SAP), shock and pancreatic necrosis. Independent risk factors related to OF included BMI, APACHE II score and SAP (P < 0.05). Age, shock and APACHE II score (P < 0.05) were the most significant factors correlated with the risk of death in NP patients. Notably, increased mortality was linked to the number of failed organs. Conclusions NP is a potentially fatal disease with a long hospital or ICU stay. Our study indicated that the incidence of OF and death in NP patients was 69.9% and 10.2%, respectively. BMI, SAP, APACHE II score, age and shock are potential risk factors of OF and death in NP patients. Clinicians should focus on these factors for early diagnosis and appropriate therapy.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and risk factors of organ failure and death in necrotizing pancreatitis

Xie

Luo

et al. 2023

BMC Gastroenterol

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“…Trikudanathan et al. suggested that decreased skeletal muscle density was independently associated with in-hospital mortality in necrotizing pancreatitis patients and can be usefully incorporated into computed tomography-based predictive scoring models as a prognostic marker ( Trikudanathan et al., 2021 ). Liu et al.…”

Section: Discussionmentioning

confidence: 99%

Non-linear correlation between amylase day 2 to day 1 ratio and incidence of severe acute pancreatitis

Hong

Zheng

et al. 2022

Front. Cell. Infect. Microbiol.

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BackgroundThis study aimed to assess whether the amylase day 2/amylase day 1 ratio was associated with severe acute pancreatitis (SAP).MethodsWe retrospectively enrolled 464 patients with acute pancreatitis. Serum amylase was measured on admission (day 1) and 24 h later (day 2). Univariable logistic regression with restricted cubic spline analysis, multivariable logistic analysis, and receiver operating characteristic curve analysis was used to evaluate the relationship between the amylase day 2/amylase day 1 ratio and SAP.ResultsA non-linear association between the amylase day 2/amylase day 1 ratio and SAP was observed. The multivariable logistic analysis confirmed that a high amylase day 2/amylase day 1 ratio (≥0.3) was independently associated with the development of SAP (OR: 6.62). The area under the receiver operating characteristic curve (AUC) of the amylase day 2/amylase day 1 ratio, as a predictive factor for SAP, was 0.65. When amylase ratio ≥0.3 was counted as 1 point and added to the BISAP score to build a new model named the BISAPA (BISAP plus Amylase ratio) score (AUC = 0.86), it improved the diagnostic power of the original BISAP score (AUC = 0.83) for SAP. With a cut-off value of 3, the BISAPA score achieved a sensitivity of 66.0%, a specificity of 86.7%, and diagnostic accuracy of 84.48%.ConclusionsThere is a non-linear correlation between the amylase day 2/amylase day 1 ratio and the incidence of SAP. BISAPA score might also be a useful tool for the same purpose.

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“…Furthermore, the effect of sarcopenia as determined by CT also conflicted with previous reports. Trikudanathan et al recently reported that decreased skeletal muscle density independently predicted mortality in necrotizing pancreatitis [ 17 ], whereas Sternby et al showed that lower muscle mass levels were associated with less severe AP [ 21 ]. These conflicting results may have been due to different patient compositions.…”

Section: Discussionmentioning

confidence: 99%

“…Several recent studies have shown that computed tomography (CT) defined muscle and adipose tissue features are associated with AP severity and mortality [17][18][19][20][21][22][23][24]. Since most patients undergo CT during the diagnosis of AP, predictions of prognosis of AP by simple body composition analyses using CT images is a cost-effective proposition.…”

Section: Introductionmentioning

confidence: 99%

“…Since most patients undergo CT during the diagnosis of AP, predictions of prognosis of AP by simple body composition analyses using CT images is a cost-effective proposition. Subcutaneous adipose tissue (SAT) are [18][19][20][21][22], visceral adipose tissue (VAT) area [17][18][19][20][21][22][23][24], skeletal muscle mass or density [17][18][19][20][21]24], visceral fat-to-muscle ratio (VMR) [21,22], and mean muscle attenuation (MMA) [19,21] have all been evaluated in the context of CT-defined body composition analysis. In addition, fatty liver has also been reported to affect AP severity [25].…”

Section: Introductionmentioning

confidence: 99%

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Impacts of body composition parameters and liver cirrhosis on the severity of alcoholic acute pancreatitis

et al. 2021

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Aim Liver cirrhosis and features of muscle or adipose tissues may affect the severity of acute pancreatitis (AP). We aimed to evaluate the impact of body composition parameters and liver cirrhosis on the severity of AP in patients with alcohol-induced AP (AAP). Methods Patients with presumed AAP who underwent CT within one week after admission were retrospectively enrolled. L3 sectional areas of abdominal fat and muscle, and mean muscle attenuations (MMAs) were quantified. The presence of liver cirrhosis was determined using clinical and CT findings. Factors potentially associated with moderately severe or severe AP were included in the multivariable logistic regression analysis. Results A total of 242 patients (47.0 ± 12.6 years, 215 males) with presumed AAP were included. The mild and moderately severe/severe (MSS) groups included 137 (56.6%) and 105 patients (43.4%), respectively. Patients in the MSS group had higher rates of liver cirrhosis, organ failure, and local complications. Among body composition parameters, mean MMA (33.4 vs 36.8 HU, P<0.0001) and abdominal muscle mass (126.5 vs 135.1 cm2, P = 0.029) were significantly lower in the MSS group. The presence of liver cirrhosis (OR, 4.192; 95% CI, 1.620–10.848) was found to be a significant risk factor for moderately severe or severe AP by multivariable analysis. Conclusion The results of this study suggest that liver cirrhosis has a significant impact on the severity of AAP. Of the body composition parameters examined, MMA and abdominal muscle mass showed potential as promising predictors.

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Decreased skeletal muscle density is an independent predictor of mortality in necrotizing pancreatitis- A single tertiary center experience in 507 patients

Cited by 12 publications

References 41 publications

Clinical characteristics and risk factors of organ failure and death in necrotizing pancreatitis

Clinical characteristics and risk factors of organ failure and death in necrotizing pancreatitis

Non-linear correlation between amylase day 2 to day 1 ratio and incidence of severe acute pancreatitis

Impacts of body composition parameters and liver cirrhosis on the severity of alcoholic acute pancreatitis

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