Risk Factors for Recurrent Pancreatitis After First Episode of Acute Pancreatitis

Abstract

In recent years, the cure rate of acute pancreatitis (AP) has increased gradually, but the morbidity of recurrent acute pancreatitis (RAP) has not decreased. Patients with RAP have a poor quality of life and are more likely to develop into chronic pancreatitis. To investigate the risk factors of RAP after first pancreatitis attack is very necessary. Methods: Patients with first episode AP admitted to Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to May 2021 were included in this retrospective study, and follow-up was 3-45 months after discharge. The patients information were collected from medical records including laboratory tests and auxiliary inspection of their hospitalization. Univariate and multivariate Cox regression analysis were used to explore the risk factors of RAP. Cumulative risk of RAP was plotted using Kaplan-Meier curves. Results: A total of 592 patients were enrolled in the study and 81 (13.7%) of the patients developed RAP. Among those RAP patients, the majority (67.9%) were men, with a median age of 43 years. The most common etiology of RAP was hypertriglyceridemia (38.3%). Multivariate Cox analysis showed that smoking history (p < 0.001), infected pancreatic necrosis occurred during first admission (p = 0.005), and high low-density lipoprotein cholesterol (LDLc) level (p < 0.001) were significant independent risk factors for RAP. Patients with the above independent risk factors had increased 3-year cumulative risk of recurrence (32.2%, 45.5%, 28.9%, respectively). Conclusion: Smoking history, infected pancreatic necrosis, and high LDLc level were the most decisive risk factors for RAP. Attention should be paid to the patients with the above factors.

Acute Pancreatitis and Type 2 Diabetes Mellitus: The Chicken–Egg Paradox—A Seven-Year Experience of a Large Tertiary Center

“…AP recurrence was not found to be linked to T2DM in our cohort, similar to the result of another study [ 24 ]. However, we believe that this result should be validated through future prospective studies as our study was a retrospective one with limitations due to its design.…”

The risk of recurrent pancreatitis after first episode of acute pancreatitis in relation to etiology and severity of disease: A systematic review, meta‐analysis and meta‐regression analysis

“…After reviewing the full text of the remaining 66 articles, 24 more articles were excluded (22 articles included patients who had more than one previous episodes of pancreatitis; two studies included the same population as one of the eligible studies). Consequently, 42 studies 8,9,14–53 (32 retrospective cohort, 8 prospective cohort, and 2 randomized controlled trials) including a total of 57 815 patients were eligible for inclusion. The study flow chart is shown in Figure 1.…”

Radiomics and Its Applications and Progress in Pancreatitis: A Current State of the Art Review

“…), and clinical characteristics (like etiology, local complications, etc.) (43)(44)(45). Chen et al (17) first showed that the radiomics model based on CECT exhibits promising value in the early prediction of RAP.…”