Characterization of patients with acute idiopathic pancreatitis using an administrative claims database in Japan

Abstract

Background: Hypertriglyceridemia is one of the causes of idiopathic acute pancreatitis and atherosclerotic cardiovascular diseases. Most guidelines define fasting triglyceride levels greater than 150 mg/dL as hypertriglyceridemia; however the triglyceride level of patients with acute pancreatitis is not clear, nor is it known how much triglyceride level reduction can reduce cardiovascular events. This study aimed to characterize patients with acute idiopathic pancreatitis and especially focused on triglyceride levels, patient characteristics, pharmaceutical treatment, and prognosis. Methods: In this retrospective analysis of an administrative claims database, patients hospitalized due to acute pancreatitis were selected, and idiopathic pancreatitis was identified using specific pre-determined ICD-10 codes. A Wilcoxon rank sum test was performed for the comparison of the means of the two cohorts, and Fisher's exact test was used to compare proportions between the cohorts. The comparison between idiopathic and non-idiopathic pancreatitis was performed using a log-rank test. Results: Between April 1, 2008, and July 31, 2021, 44,005 patients were hospitalized for the treatment of pancreatitis; among them, 30,814 cases (70.0%) were categorized as idiopathic. The mean age of patients with idiopathic pancreatitis was 62.7±18.8 years, 68.8% of the patients were male, and the mean triglyceride levels within 3 days after hospitalization were 293.1±816.6 mg/dL. Rehospitalization due to recurrent pancreatitis and the incidence rates of cardiovascular events were 39.5% and 3.3%, respectively. Conclusions: Patients with idiopathic pancreatitis had elevated triglyceride levels at admission. Even if triglyceride levels are not extremely high, hypertriglyceridemia might cause idiopathic pancreatitis. Therefore, there is a need for intervention in terms of triglyceride levels in patients with hypertriglyceridemia, not only to prevent cardiovascular disease, but also to prevent the onset and recurrence of acute pancreatitis. Trial registration: Not applicable