Journal article
The clinical characteristic of biliary-hyperlipidemic etiologically complex type of acute pancreatitis: a retrospective study from a tertiary center in China
European review for medical and pharmacological sciences, Vol.25(3), pp.1462-1471
02/2021
DOI: 10.26355/eurrev_202102_24854
PMID: 33629316
Abstract
OBJECTIVE: Biliary and hyperlipidemic acute pancreatitis (AP) has become the second most common AP in China. Currently, AP is exclusively diagnosed as biliary or hyperlipidemic AP. However, as suggested by some reports, biliary and hyperlipidemic AP might coexist in a single patient. Moreover, acute lipotoxicity was shown to regulate the severity of biliary AP in the mouse model. Thus, whether these two etiologies coexist in AP patients and potentially worsen the clinical course remains unclear. To elucidate the clinical feature of a new complex type of acute pancreatitis with both biliary and hyperlipidemic etiologies.
PATIENTS AND METHODS: This retrospective study included AP patients who were admitted into our department within 7 days after the onset of the disease. 267 AP patients were enrolled in this study and were classified as BAP (biliary acute pancreatitis, n=153), HLAP (hyperlipidemic acute pancreatitis, n=65) and BHAP (biliary-hyperlipidemic acute pancreatitis, n=49). All the enrolled patients met the classification criteria of biliary etiology, hyperlipidemic etiology, and both etiologies, respectively. BHAP was compared with BAP and HLAP in terms of general information, inflammatory biomarkers, organ dysfunction, disease severity and clinical outcomes.
RESULTS: BHAP (41 vs. 53) patients were younger than BAP patients. Serum procalcitonin of BHAP patients was higher than BAP and HLAP patients. Serum CRP of BHAP patients was higher than BAP patients. BHAP patients had the highest diagnosis rate of severe acute pancreatitis (SAP) (46.9% vs. 17.6% or 21.5%) compared to BAP and HLAP. Prevalences of persistent respiratory, acute renal, and circulatory failure were highest in BHAP patients (44.9%, 28.6%, 12.2%, respectively). Requirements for mechanical ventilation, renal replacement therapy and vasoactive agents were also highest in BHAP patients (36.7%, 34.7%, 12.2%, respectively). Hospital stay was longer in BHAP patients (33 days) compared with BAP patients (24 days).
CONCLUSIONS: Patients with both biliary and hyperlipidemic etiologies suffer from more severe clinical course of the disease and have worse prognosis than single-etiology BAP or HLAP patients in the early stage of AP (within 7 days). It should be recognized as a new etiological type named biliary-hyperlipidemic acute pancreatitis (BHAP).
Details
- Title: Subtitle
- The clinical characteristic of biliary-hyperlipidemic etiologically complex type of acute pancreatitis: a retrospective study from a tertiary center in China
- Creators
- Y-H Wang - Shanghai Jiao Tong UniversityZ-H Xu - Shanghai Jiao Tong UniversityY-H Zhou - Shanghai Jiao Tong UniversityS-L Sun - Shanghai Jiao Tong UniversityZ-W Xu - Shanghai Jiao Tong UniversityX. Qi - Shanghai Jiao Tong UniversityW-J Zhou - Shanghai Jiao Tong UniversityH-Q Sheng - Shanghai Jiao Tong UniversityB. Zhao - Shanghai Jiao Tong UniversityE-Q Mao - Shanghai Jiao Tong University
- Resource Type
- Journal article
- Publication Details
- European review for medical and pharmacological sciences, Vol.25(3), pp.1462-1471
- Publisher
- Verduci Publisher
- DOI
- 10.26355/eurrev_202102_24854
- PMID
- 33629316
- ISSN
- 1128-3602
- eISSN
- 2284-0729
- Number of pages
- 10
- Language
- English
- Date published
- 02/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984696656502771
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