P2108 - Acute Pancreatitis from Hypertriglyceridemia Is More Severe and Associated with Longer Length of Stay

David S. Braun, MD, Shruti Patel, MD, Paul Tarnasky, MD
Methodist Dallas Medical Center, Dallas, TX

Introduction: Hypertriglyceridemia (HTG) is a relatively uncommon cause of Acute Pancreatitis (AP) representing < 10% of cases. Studies comparing outcomes of HTG-AP with other causes of AP have yielded inconsistent results, likely due in part to non-standardized AP management, which lead to varied outcomes and prognosis in HTG-AP patients. This study aimed to investigate the clinical characteristics and outcomes of patients admitted with HTG-AP versus AP from other etiologies.

Methods: This single-center study compared the clinical course and outcomes of AP patients from January 2015 to August 2020. All of the patients presenting with AP were diagnosed and managed according to a standardized protocol (Methodist Acute Pancreatitis Protocol) which is comprised of computer physician orders (e.g. fluid resuscitation, enteral feeding), physician and nursing education, and a patient navigator to optimize adherence to AP published guidelines (APPG). Measured outcomes included length of stay (LOS), in-patient mortality, 30-day readmission, and final pancreatitis severity characterized as mild, moderately severe, or severe as defined by the APPG. Fisher's exact test and Wilcoxon rank-sum (Mann-Whitney) tests were used for statistical analyses.

Results: Data from 42 patients admitted with HTG-AP and 243 patients with non-HTG-AP were analyzed (Table 1). The mean age (SD) was 39.95 (± 10.95) years for the HTG-AP group and 50.55 (± 17.78) years for the non-HTG-AP group (p=0.0003). The mean LOS was 7.74 (± 11.54) days for the HTG-AP group and 4.20 (± 4.16) days for the non-HTG-AP group (p=0.0014). Also, 9.52% of the HTG-AP group and 2.88% of the non-HTG-AP group had severe pancreatitis. The odds of having moderately severe and severe pancreatitis were higher than mild AP in the HTG group compared to that in the non-HTG group. The difference in mortality between the HTG-AP group (0%) and non-HTG-AP group (1.65%) was not statistically significant (p=1.000). Thirty-day readmission rates were 7.14% for the HTG-AP group and 2.93% for the non-HTG-AP group (p=0.175).

Discussion: The HTG-AP group had a longer LOS and higher pancreatitis severity compared to the non-HTG-AP group, despite the fact that all patients were managed with a standardized early medical management protocol. These findings suggest a need to improve risk stratification based on AP etiology and identify opportunities to improve management of HTG-AP.

	HTG (N=42)	Non-HTG (N=243)	P value
Age (years, mean ± SD)	39.95 ± 10.95	50.55 ± 17.78	0.0003
Mild Pancreatitis (n, %)	27 (64.29%)	208 (85.6%)	0.003
Moderately Severe Pancreatitis (n, %)	11 (26.11%)	28 (11.52%)	0.003
Severe Pancreatitis (n, %)	4 (9.52%)	7 (2.88%)	0.003
Length of Stay (days, mean ± SD)	7.74 ± 11.54	4.20 ± 4.16	0.0014
In-patient Mortality (n, %)	0	4 (1.65%)	1.000
30-day readmission (n, %)	3 (7.14%)	7 (2.93%)	0.175

Table: Table 1: Differences in demographics and outcomes between patients with hypertriglyceridemia acute pancreatitis and acute pancreatitis from other etiologies.


Disclosures:
David Braun indicated no relevant financial relationships.
Shruti Patel indicated no relevant financial relationships.
Paul Tarnasky indicated no relevant financial relationships.


David S. Braun, MD, Shruti Patel, MD, Paul Tarnasky, MD. P2108 - Acute Pancreatitis from Hypertriglyceridemia Is More Severe and Associated with Longer Length of Stay, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.