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

Abstract

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.

Predicting Severity of Acute Pancreatitis

“…Furthermore, the pleural effusion volume was associated with the duration of admission, and CRP levels showed the possibility of a reliable radiologic predictor of the severity of AP [38]. Subcutaneous or visceral adipose tissue, skeletal muscle mass or density, and mean muscle attenuation were evaluated in the context of CT defined body composition analysis, and reported promising results for the prediction of AP severity; however, a lack of prospective studies of different races is hurdle to overcome [39,40].…”

High risk of complications and mortality in cirrhotic patients with acute pancreatitis

“…Cirrhosis prevalence was 2.8%, with significantly higher morbidity and mortality [9]. In the last available retrospective study, coexistent cirrhosis (in 32 (13%) of 242 patients with acute alcoholic pancreatitis) was independently associated with a severe course of the pancreatitis [10].…”