Fatty liver predicts greater severity of acute pancreatitis

  • Hou S & al.
  • Int J Surg
  • 12 Apr 2019

  • International Clinical Digest
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Takeaway

  • Fatty liver was associated with greater severity of acute pancreatitis in a meta-analysis.

Why this matters

  • Prior studies have made the association between fatty liver and pancreatitis incidence, but not severity.

Study design

  • Meta-analysis of 4 studies involving patients with acute pancreatitis in presence (n=805) or absence (n=1026) of fatty liver.
  • Funding: National Nature Science Foundation of China.   

Key results

  • Fatty liver was associated with increased incidence of:
    • Persistent organ failure (>48 hours; OR=2.32; P=.002; I2=26.4%).
    • Systemic complications (OR=3.60; P<.001 i>2=0%).
    • Systemic inflammatory response syndrome (OR=2.82; P<.001 i>2=0%).
    • Metabolic disturbance (OR=3.90; P<.001 i>2=0%).
    • Mortality (OR=4.16; P<.001 i>2=0%).
    • Local complications (all P<.001 including acute necrotic collection>2=51.7%), peripancreatic fluid collection (OR=4.10; I2=0%), and pancreatic pseudocyst (OR=2.79; I2=0%).
  • Using revised Atlanta classification, fatty liver was associated with increased incidence of:
    • Moderately severe pancreatitis (OR=2.72; P<.001 i>2=70.8%).
    • Severe pancreatitis (OR=3.57; P<.001 i>2=73.9%).
  • Fatty liver was tied to worse prognosis of acute pancreatitis in stratified analyses by presence of obesity and alcohol abuse.

Limitations

  • Studies were from Korea, China, and Croatia.
  • Few studies; relatively small sample size.
  • Heterogeneity (I2 statistic).

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