TY - JOUR
T1 - Obesity and alcoholic etiology as risk factors for multisystem organ failure in acute pancreatitis
T2 - Multinational study
AU - Lee, Peter J.
AU - Lahooti, Ali
AU - Culp, Stacey
AU - Boutsicaris, Andrew
AU - Holovach, Phillip
AU - Wozniak, Kayla
AU - Lahooti, Ila
AU - Paragomi, Pedram
AU - Hinton, Alice
AU - Pothoulakis, Ioannis
AU - Talukdar, Rupjyoti
AU - Kochhar, Rakesh
AU - Goenka, Mahesh K.
AU - Gulla, Aiste
AU - Gonzalez, Jose A.
AU - Singh, Vikesh
AU - Bogado, Miguel Ferreira
AU - Stevens, Tyler
AU - Babu, Sorin Traian
AU - Nawaz, Haq
AU - Gutierrez, Silvia Cristina
AU - Zarnescu, Narcis
AU - Capurso, Gabriele
AU - Easler, Jeffrey
AU - Triantafyllou, Konstantinos
AU - Peláez Luna, Mario
AU - Thakkar, Shyam
AU - Ocampo, Carlos
AU - de-Madaria, Enrique
AU - Cote, Gregory A.
AU - Wu, Bechien U.
AU - Hart, Phil A.
AU - Krishna, Somashekar G.
AU - Lara, Luis
AU - Han, Samuel
AU - Papachristou, Georgios I.
N1 - Publisher Copyright:
© 2023 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.
PY - 2023/5
Y1 - 2023/5
N2 - Background: Multisystem organ failure (MSOF) is the most important determinant of mortality in acute pancreatitis (AP). Obesity and alcoholic etiology have been examined as potential risk factors for MSOF, but prior studies have not adequately elucidated their independent effects on the risk of MSOF. Objective: We aimed to determine the adjusted effects of body mass index (BMI) and alcoholic etiology on the risk of MSOF in subjects with AP. Methods: A prospective observational study of 22 centers from 10 countries was conducted. Patients admitted to an APPRENTICE consortium center with AP between August 2015 and January 2018 were enrolled. Multivariable logistic regression was used to estimate the adjusted effects of BMI, etiology, and other relevant covariates on the risk of MSOF. Models were stratified by sex. Results: Among 1544 AP subjects, there was a sex-dependent association between BMI and the risk of MSOF. Increasing BMI was associated with increased odds of MSOF in males (OR 1.10, 95% confidence interval [CI] 1.04–1.15) but not in females (OR 0.98, 95% CI 0.90–1.1). Male subjects with AP, whose BMIs were 30–34 and >35 kg/m2, had odds ratios of 3.78 (95% CI 1.62–8.83) and 3.44 (95% CI 1.08–9.99), respectively. In females, neither higher grades of obesity nor increasing age increased the risk of MSOF. Alcoholic etiology was independently associated with increased odds of MSOF compared with non-alcohol etiologies (OR 4.17, 95% CI 2.16–8.05). Conclusion: Patients with alcoholic etiology and obese men (but not women) are at substantially increased risk of MSOF in AP.
AB - Background: Multisystem organ failure (MSOF) is the most important determinant of mortality in acute pancreatitis (AP). Obesity and alcoholic etiology have been examined as potential risk factors for MSOF, but prior studies have not adequately elucidated their independent effects on the risk of MSOF. Objective: We aimed to determine the adjusted effects of body mass index (BMI) and alcoholic etiology on the risk of MSOF in subjects with AP. Methods: A prospective observational study of 22 centers from 10 countries was conducted. Patients admitted to an APPRENTICE consortium center with AP between August 2015 and January 2018 were enrolled. Multivariable logistic regression was used to estimate the adjusted effects of BMI, etiology, and other relevant covariates on the risk of MSOF. Models were stratified by sex. Results: Among 1544 AP subjects, there was a sex-dependent association between BMI and the risk of MSOF. Increasing BMI was associated with increased odds of MSOF in males (OR 1.10, 95% confidence interval [CI] 1.04–1.15) but not in females (OR 0.98, 95% CI 0.90–1.1). Male subjects with AP, whose BMIs were 30–34 and >35 kg/m2, had odds ratios of 3.78 (95% CI 1.62–8.83) and 3.44 (95% CI 1.08–9.99), respectively. In females, neither higher grades of obesity nor increasing age increased the risk of MSOF. Alcoholic etiology was independently associated with increased odds of MSOF compared with non-alcohol etiologies (OR 4.17, 95% CI 2.16–8.05). Conclusion: Patients with alcoholic etiology and obese men (but not women) are at substantially increased risk of MSOF in AP.
KW - acute pancreatitis
KW - alcoholic pancreatitis
KW - multi-system organ failure
KW - obesity
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U2 - 10.1002/ueg2.12390
DO - 10.1002/ueg2.12390
M3 - Article
C2 - 37096304
AN - SCOPUS:85153603500
SN - 2050-6406
VL - 11
SP - 383
EP - 391
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 4
ER -