Fibrinogen and coagulation factor VIII levels as indicators of disease severity in Hyperlipidemic Acute Pancreatitis: A comparison with biliary etiology.

Background and aims: Research on the variance of coagulation factors in acute pancreatitis (AP) with different etiologies remains limited. This study aims to explore the coagulation profiles in patients with biliary AP (BAP) and hyperlipidemic AP (HLAP), focusing on their role in predicting disease severity.

Methods: A single-center retrospective cohort study was conducted on patients diagnosed with BAP or HLAP at Beijing Chaoyang Hospital from January 2020 to December 2021.

Results: A total of 112 patients were enrolled, including 43 with BAP and 69 with HLAP. Among these, 82 had mild acute pancreatitis (MAP) and 30 had moderately severe acute pancreatitis (MSAP). HLAP patients had significantly higher levels of fibrinogen, protein C, coagulation factors II and X compared to BAP patients. Receiver Operating Characteristic (ROC) analysis identified fibrinogen, with an area under the curve (AUC) of 0.721, and coagulation factor VIII(FVIII), with an AUC of 0.700, as significant predictors of disease severity in HLAP. Correlation analysis showed significant associations between fibrinogen and FVIII with Ranson and computed tomography severity index (CTSI) scores, as well as positive correlations with cholesterol and triglyceride levels in these patients.

Conclusion: Compared with BAP, HLAP patients exhibit significant coagulation disorders from the mild stages. Fibrinogen and FVIII may be useful biomarkers for assessing HLAP severity.