Patients Admitted with Acute pancreatitis and Dyslipidemia Affected by Non-Alcoholic Fatty Liver Disease are Associated with Worse Clinical Outcomes

Abstract

Background/Synopsis

Individuals with NAFLD may have alterations in lipid metabolism, insulin resistance, and an increased risk of dyslipidemia, all of which can contribute to the development of acute pancreatitis. Dyslipidemia, particularly elevated triglycerides and low-density lipoprotein cholesterol (LDL-C), is often seen in individuals with NAFLD. Insulin resistance and metabolic syndrome are common underlying factors.

Objective/Purpose

There is limited scientific evidence of clinical outcomes of NAFLD in patients admitted with acute pancreatitis & dyslipidemia. Hence, we sought to investigate this population.

Methods

We queried National Inpatient Sample between 2017-2020 for adult patients who were hospitalized with acute pancreatitis & dyslipidemia with NAFLD. The primary outcome was inpatient mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, gastrointestinal bleeding (GIB), acute kidney injury (AKI), intubation, length of stay (LOS) and total hospital charge. Multivariable logistic regression analysis was used to estimate clinical outcomes. P-value < 0.05 was significant.

Results

There were 574,269 hospitalizations with acute pancreatitis and dyslipidemia where 29,324 (5.1%) had NAFLD. NAFLD and non-NAFLD cohorts were with mean age of 61.5 vs. 60 yrs; males 54.5% vs 56.2%; Caucasians 65.0% both; HTN 49% vs 56%; HF 18.8% vs 12%; obesity 27% vs 24%; Metabolic Syndrome 9.6% vs 8.7%; DKA 3.9% vs 4.9%; AF 24.4% vs 23.5%; AKI 38% vs 21.8%; obesity 30.3% vs 29.3%; ACS 6.6% vs 2.8%; acute respiratory failure 17.8% vs 6.4%; history of stroke 0.9% vs 0.4%; COPD 15% vs 13.5%; alcohol use 19.9% vs 18.5%, respectively. NAFLD cohort had significantly higher mortality and worse clinical outcomes (Table 1).

Conclusions

NAFLD group demonstrated significantly higher mortality, worse clinical outcomes and resource utilization. Patients were older, obese, female, same Caucasian population, with more frequent HF, AF, ACS and alcohol use. NAFLD is associated with greater risk for cardiovascular events, renal failure, GIB, and ICU care. NAFLD is an important predictor of adverse outcomes in acute pancreatitis & dyslipidemia population. Further research is necessary to describe long-term outcomes.