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Rijk, F.E.M. de; Sissingh, N.J.; Boel, T.T.; Timmerhuis, H.C.; Jong, M.J.P. de; Pauw, H.S.; ... ; Dutch Pancreatitis Study Grp (2024)

Development of pancreatic diseases during long-term follow-up after acute pancreatitis: a post-hoc analysis of a prospective multicenter cohort

Article / Letter to editor
Background and AimMore insight into the incidence of and factors associated with progression following a first episode of acute pancreatitis (AP) would offer opportunities for improvements in disease management and patient counseling.MethodsA long-term post hoc analysis of a prospective cohort of patients with AP (2008-2015) was performed. Primary endpoints were recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), and pancreatic cancer. Cumulative incidence calculations and risk analyses were performed.ResultsOverall, 1184 patients with a median follow-up of 9 years (IQR: 7-11) were included. RAP and CP occurred in 301 patients (25%) and 72 patients (6%), with the highest incidences observed for alcoholic pancreatitis (40% and 22%). Pancreatic cancer was diagnosed in 14 patients (1%). Predictive factors for RAP were alcoholic and idiopathic pancreatitis (OR 2.70, 95% CI 1.51-4.82 and OR 2.06, 95% CI 1.40-3.02), and no pancreatic interventions (OR 1.82, 95% CI 1.10-3.01)...Show moreBackground and AimMore insight into the incidence of and factors associated with progression following a first episode of acute pancreatitis (AP) would offer opportunities for improvements in disease management and patient counseling.MethodsA long-term post hoc analysis of a prospective cohort of patients with AP (2008-2015) was performed. Primary endpoints were recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), and pancreatic cancer. Cumulative incidence calculations and risk analyses were performed.ResultsOverall, 1184 patients with a median follow-up of 9 years (IQR: 7-11) were included. RAP and CP occurred in 301 patients (25%) and 72 patients (6%), with the highest incidences observed for alcoholic pancreatitis (40% and 22%). Pancreatic cancer was diagnosed in 14 patients (1%). Predictive factors for RAP were alcoholic and idiopathic pancreatitis (OR 2.70, 95% CI 1.51-4.82 and OR 2.06, 95% CI 1.40-3.02), and no pancreatic interventions (OR 1.82, 95% CI 1.10-3.01). Non-biliary etiology (alcohol: OR 5.24, 95% CI 1.94-14.16, idiopathic: OR 4.57, 95% CI 2.05-10.16, and other: OR 2.97, 95% CI 1.11-7.94), RAP (OR 4.93, 95% CI 2.84-8.58), prior pancreatic interventions (OR 3.10, 95% CI 1.20-8.02), smoking (OR 2.33, 95% CI 1.14-4.78), and male sex (OR 2.06, 95% CI 1.05-4.05) were independently associated with CP.ConclusionDisease progression was observed in a quarter of pancreatitis patients. We identified several risk factors that may be helpful to devise personalized strategies with the intention to reduce the impact of disease progression in patients with AP.Show less
acute pancreatitis
chronic pancreatitis
pancreatic cancer
progression
All authors
Rijk, F.E.M. de; Sissingh, N.J.; Boel, T.T.; Timmerhuis, H.C.; Jong, M.J.P. de; Pauw, H.S.; Veldhuisen, C.L. van; Hallensleben, N.D.; Anten, M.P.G.F.; Brink, M.A.; Curvers, W.L.; Duijvendijk, P. van; Hazen, W.L.; Kuiken, S.D.; Poen, A.C.; Quispel, R.; Roemkens, T.E.H.; Spanier, B.W.M.; Tan, A.C.I.T.L.; Vleggaar, F.P.; Voorburg, A.M.C.J.; Witteman, B.J.M.; Ali, U.A.; Issa, Y.; Bouwense, S.A.W.; Voermans, R.P.; Wanrooij, R.L.J. van; Stommel, M.W.J.; Hooft, J.E. van; Jonge, P.J. de; Goor, H. van; Boermeester, M.A.; Besselink, M.G.; Bruno, M.J.; Verdonk, R.C.; Santvoort, H.C. van; Dutch Pancreatitis Study Grp
Date
2024-01-08
Journal
Journal of Gastroenterology and Hepatology
Volume
39
Issue
4
Pages
674 - 684
DOI
doi:10.1111/jgh.16453