Dataset Information

Relationship between Plasma Triglyceride Level and Severity of Hypertriglyceridemic Pancreatitis.

ABSTRACT:

Background

Hypertriglyceridemia is the third most common cause of acute pancreatitis, but whether the level of triglyceride (TG) is related to severity of pancreatitis is unclear.

Aim

To evaluate the effect of TG level on the severity of hypertriglyceridemic pancreatitis (HTGP).

Design

Retrospective cohort study.

Methods

We reviewed the records of 144 patients with HTGP from 1999 to 2013 at Tri-Service General Hospital. Patients with possible etiology of pancreatitis, such as gallstones, those consuming alcohol or drugs, or those with infections were excluded. The classification of severity of pancreatitis was based on the revised Atlanta classification. We allocated the patients into high-TG and low-TG groups based on the optimal cut-off value (2648 mg/dL), which was derived from the receiver operating characteristic (ROC) curve between TG level and severity of HTGP. We then compared the clinical characteristics, pancreatitis severity, and mortality rates of the groups.

Results

There were 66 patients in the low-TG group and 78 patients in the high-TG group. There was no significant difference in the age, sex ratio, body mass index, and comorbidity between the 2 groups. The high-TG group had significantly higher levels of glucose (P = 0.022), total cholesterol (P = 0.002), and blood urea nitrogen (P = 0.037), and lower levels of sodium (P = 0.003) and bicarbonate (P = 0.002) than the low-TG group. The incidences of local complication (P = 0.002) and severe and moderate form of pancreatitis (P = 0.004) were significantly higher in the high-TG group than in the low-TG group. The mortality rate was higher in the high-TG group than in the low-TG group (P = 0.07).

Conclusions

Higher TG level in patients with HTGP may be associated with adverse prognosis, but randomized and prospective studies are needed in the future verify this relationship.

SUBMITTER: Wang SH

PROVIDER: S-EPMC5058492 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Relationship between Plasma Triglyceride Level and Severity of Hypertriglyceridemic Pancreatitis.

Wang Sheng-Huei SH Chou Yu-Ching YC Shangkuan Wei-Chuan WC Wei Kuang-Yu KY Pan Yu-Han YH Lin Hung-Che HC

PloS one 20161011 10

<h4>Background</h4>Hypertriglyceridemia is the third most common cause of acute pancreatitis, but whether the level of triglyceride (TG) is related to severity of pancreatitis is unclear.<h4>Aim</h4>To evaluate the effect of TG level on the severity of hypertriglyceridemic pancreatitis (HTGP).<h4>Design</h4>Retrospective cohort study.<h4>Methods</h4>We reviewed the records of 144 patients with HTGP from 1999 to 2013 at Tri-Service General Hospital. Patients with possible etiology of pancreatitis ...[more]

PMID: 27727299

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Project description:ObjectivesThe optimal therapy for hypertriglyceridemic acute pancreatitis, especially the role of plasma exchange (PE), is not entirely clear. The aim of our large, single-center, observational, cohort study was to analyze the factors affecting outcome in hypertriglyceridemic pancreatitis treated with PE.MethodsWe included 111 episodes of hypertriglyceridemic pancreatitis treated with PE, which occurred in 103 different patients. The Acute Physiology and Chronic Health Evaluation (APACHE) II score, triglycerides, delay to first PE, and PE treatment details were retrospectively obtained from the patients' records. The main outcome measures were length of hospitalization and in-hospital mortality.ResultsThe patients were 47±9 years old and the median APACHE II score at first PE was 4 (inter-quartile range (IQR) 2-7). There was a seasonal variation in the incidence of hypertriglyceridemic pancreatitis, and the recurrence rate was 1.6% per year. Triglycerides at presentation did not correlate with APACHE II or influence the outcome. The mean reduction in triglycerides during PE was 59% (from 44±31 to 18±15 mmol/l), which was twice the reduction observed during conservative treatment (27% daily). The median hospital stay was 16 days (IQR 10-24) and in-hospital mortality was 5%. The median delay to first PE was 35 hours (IQR 24-52), and there was no difference in mortality in the early and late PE groups (7% vs. 6%, p?=?0.79). The group with citrate anticoagulation during PE had a significantly lower mortality than the group with heparin anticoagulation (1% vs. 11%, p?=?0.04), and citrate was an independent predictor also in the multivariate model (p?=?0.049).ConclusionsPE effectively reduced serum triglycerides faster than could be expected with conservative treatment. The delay in PE therapy did not influence survival. We found that citrate anticoagulation during PE was associated with reduced mortality, which should be confirmed in a randomized study.

Dataset Information

Relationship between Plasma Triglyceride Level and Severity of Hypertriglyceridemic Pancreatitis.

Background

Aim

Design

Methods

Results

Conclusions

Publications

Relationship between Plasma Triglyceride Level and Severity of Hypertriglyceridemic Pancreatitis.

Similar Datasets

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