Liver cirrhosis, age, and bilirubin could be prognostic for mortality in pancreatitis

Background and Aim Alcohol abuse and subsequent alcohol-related liver disease and pancreatitis are still among the most common hepatological diseases for hospital admittance in industrialized societies. It remains unclear why excessive alcohol use leads to either liver cirrhosis (LC) in some patients or an acute/chronic pancreatitis in others or both. In our study we analyzed patient data from a single-center retrospectively to elucidate potential risk factors and/or characteristics, trying to understand better, which patients with alcoholic abuse disorder develop pancreatitis alone or in combination with liver cirrhosis.

Method In a retrospective single-center study data of 625 patients was analyzed, who were admitted to the University Hospital Magdeburg because of acute or chronic pancreatitis or developed it during their stay between 2013 and 2017. We further analyzed which of these patients had LC or had been diagnosed with it during their hospital stay. Epidemiological data, serum parameters and, where available, liver steatosis were analyzed for patients with either alcohol-related or biliary-obstructive pancreatitis.

Results After exclusion of patients with incomplete data or other etiologies for pancreatitis 403 patients were included in the study. 279 were male and 124 were female; 198 suffered from an alcohol-related pancreatitis and 205 from biliary pancreatitis. Relatively more men suffered from alcoholic-related than biliary pancreatitis and patients with biliary pancreatitis were older. Prevalence of steatosis and LC and mortality did not differ between etiologies. For alcohol-related pancreatitis higher serum levels of AST, AP, and bilirubin were predictive of LC. In patients with biliary pancreatitis lower serum ALT concentrations and higher creatinine were associated with LC. Risk factors for mortality were analyzed combined for both etiologies, as only 21 patients deceased in the whole cohort. Presence of LC, older age, and higher serum concentrations of bilirubin, AP, and creatinine were associated with mortality.

Conclusion Pancreatitis related to alcohol or biliary cause differ in serum derived factors and gender distribution but not in clinical presentation. LC, age, bilirubin, creatinine, and AP could be prognostic factors for outcome in pancreatitis independent of etiology.

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Artikel online veröffentlicht:
04. Januar 2021