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Clinical Outcomes of Acute Pancreatitis in Patients with Cirrhosis According to Liver Disease Severity Scores

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Abstract

Background

Literature on acute pancreatitis (AP) outcomes in patients with cirrhosis is limited. We aim to investigate the mortality and morbidity of AP in patients with cirrhosis.

Methods

We conducted a retrospective cohort study, and propensity score matching was done to match cirrhotic with non-cirrhotic patients on a 1:2 basis. Outcomes included inpatient mortality, organs failure, systemic inflammatory response syndrome, and length of hospital stay. We performed subgroup analysis of cirrhotics according to Child–Pugh and MELD scores. Multivariable logistic regression models were tested.

Results

From 819 AP patients, cirrhosis prevalence was 4.9% (40). There was no significant difference between cirrhotics and non-cirrhotics for inpatient mortality (7.5% vs. 1.3%, p = 0.1), severe AP (17.5% vs. 7.5%), shock (7.9% vs. 3%), respiratory failure (10% vs. 3.8%), need for intensive care unit (15% vs. 6.3%), systemic inflammatory response syndrome (SIRS) on admission (22.5% vs. 32.5%), and SIRS on day 2 (25% vs. 15%). Cirrhotics had similar rates of pancreatic necrosis, ileus, BISAP score, Marshall score, admission hematocrit, BUN, and hospital length of stay. Finally, cirrhotics who had severe AP, required ICU, and/or die in-hospital appeared to have more severe liver diseases (Child-C, higher MELD score > 17) and had lower AP severity scores (BISAP < 3, Marshall scores < 2).

Conclusion

In our study, cirrhotics hospitalized with AP had similar morbidity and mortality when compared to non-cirrhotics.

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Authors and Affiliations

  1. Gastroenterology, Hepatology, and Nutrition Department, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    C. Roberto Simons-Linares, Suha Abushamma, Carlos Romero-Marrero, Amit Bhatt, Rocio Lopez, Sunguk Jang, John Vargo, Tyler Stevens, Robert O’Shea, William Carey & Prabhleen Chahal

Authors
  1. C. Roberto Simons-Linares
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  2. Suha Abushamma
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  3. Carlos Romero-Marrero
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  4. Amit Bhatt
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  5. Rocio Lopez
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  6. Sunguk Jang
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  7. John Vargo
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  8. Tyler Stevens
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  9. Robert O’Shea
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  10. William Carey
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  11. Prabhleen Chahal
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Corresponding author

Correspondence to Prabhleen Chahal.

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Simons-Linares, C.R., Abushamma, S., Romero-Marrero, C. et al. Clinical Outcomes of Acute Pancreatitis in Patients with Cirrhosis According to Liver Disease Severity Scores. Dig Dis Sci 66, 2795–2804 (2021). https://doi.org/10.1007/s10620-020-06575-x

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  • DOI: https://doi.org/10.1007/s10620-020-06575-x

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