D0008 - Females Develop Less Severe Acute Pancreatitis: A Multivariate Analysis Controlled for Etiology and Core Factors

Mimi Xu, MD¹, David Lehoang, MD, MBA¹, Thu Anne Mai, MD¹, Jin Sun Kim, MD¹, Linda Huang, MD¹, Yousuf Kidwai, MD¹, Niwen Kong, MD¹, Kevin Yu, MD¹, Rachel Dong, MD¹, Collin Mayemura, MD¹, Selena Zhou, MD¹, Aneesa Chowdhury, MD¹, Patrick W. Chang, MD¹, James L. Buxbaum, MD^2
1University of Southern California, Los Angeles, CA; ²Keck School of Medicine, University of Southern California, Los Angeles, CA

Introduction: In gastrointestinal diseases such as alcohol-associated liver disease, gender has been shown to be an independent risk factor for severity due to differences in first-pass metabolism of alcohol, Kupffer cell activation, and hormones. We aim to describe the impact of gender on the clinical course of acute pancreatitis (AP).

Methods: We prospectively characterized a cohort of unique patients presenting between January 2015 to March 2021 with AP. Our primary outcome was the development of moderately severe or severe pancreatitis (as defined by the Revised Atlanta Classification) and our primary predictor was gender. Linear and multivariate logistic regression analyses were performed, controlling for both patient (age, ethnicity, BMI) and clinical (etiology of AP, comorbidities, fluids administered in first 48 hours) factors.

Results: 1473 patients presented with AP. Of this cohort, 45% were female, the mean (±SD) age was 45 (±16), and 82% were Hispanic. 1176 (79.8%) patients presented with mild AP and 297 (20.2%) patients presented with moderately severe or severe AP. Age and amount of fluids given in the initial 48 hours did not differ between genders, however, females had a higher mean BMI (29.43 vs 28.22; P=0.003). Males presented with alcohol AP more frequently (40.7% vs 6.1%; P < 0.001), whereas females presented with gallstone AP more frequently (59.2% vs 28.6%; P < 0.001). Other causes of AP were equally distributed between genders (P=0.120). When controlled for etiology as well as age, ethnicity, BMI, comorbidities, and fluid administration, females were less likely to present with moderately severe or severe pancreatitis (OR 0.606; 95% CI 0.435-0.844). They were also less likely to develop necrotizing AP, pancreatic pseudocysts, organ failure, and require ICU level of care (Table).

Discussion: Females are less likely to present with moderately severe or severe AP compared to males when controlled for etiology and core factors. This may be due to sex-specific steroid stress responses or the effects of estrogen on the pancreas. Further studies are needed to confirm these findings and elucidate the mechanism.


Disclosures:


Mimi Xu, MD¹, David Lehoang, MD, MBA¹, Thu Anne Mai, MD¹, Jin Sun Kim, MD¹, Linda Huang, MD¹, Yousuf Kidwai, MD¹, Niwen Kong, MD¹, Kevin Yu, MD¹, Rachel Dong, MD¹, Collin Mayemura, MD¹, Selena Zhou, MD¹, Aneesa Chowdhury, MD¹, Patrick W. Chang, MD¹, James L. Buxbaum, MD². D0008 - Females Develop Less Severe Acute Pancreatitis: A Multivariate Analysis Controlled for Etiology and Core Factors, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.