S106 Acute Pancreatitis from Hypertriglyceridemia Is More Severe and Associated with Longer Length of Stay

Abstract

Introduction: Hypertriglyceridemia (HTG) is a relatively uncommon cause of Acute Pancreatitis (AP) representing <10% of cases. Studies comparing outcomes of HTG-AP with other causes of AP have yielded inconsistent results, likely due in part to non-standardized AP management, which lead to varied outcomes and prognosis in HTG-AP patients. This study aimed to investigate the clinical characteristics and outcomes of patients admitted with HTG-AP versus AP from other etiologies. Methods: This single-center study compared the clinical course and outcomes of AP patients from January 2015 to August 2020. All of the patients presenting with AP were diagnosed and managed according to a standardized protocol (Methodist Acute Pancreatitis Protocol) which is comprised of computer physician orders (e.g. fluid resuscitation, enteral feeding), physician and nursing education, and a patient navigator to optimize adherence to AP published guidelines (APPG). Measured outcomes included length of stay (LOS), in-patient mortality, 30-day readmission, and final pancreatitis severity characterized as mild, moderately severe, or severe as defined by the APPG. Fisher's exact test and Wilcoxon rank-sum (Mann-Whitney) tests were used for statistical analyses. Results: Data from 42 patients admitted with HTG-AP and 243 patients with non-HTG-AP were analyzed (Table 1). The mean age (SD) was 39.95 (± 10.95) years for the HTG-AP group and 50.55 (± 17.78) years for the non-HTG-AP group (P=0.0003). The mean LOS was 7.74 (± 11.54) days for the HTG-AP group and 4.20 (± 4.16) days for the non-HTG-AP group (P=0.0014). Also, 9.52% of the HTG-AP group and 2.88% of the non-HTG-AP group had severe pancreatitis. The odds of having moderately severe and severe pancreatitis were higher than mild AP in the HTG group compared to that in the non-HTG group. The difference in mortality between the HTG-AP group (0%) and non-HTG-AP group (1.65%) was not statistically significant (P=1.000). Thirty-day readmission rates were 7.14% for the HTG-AP group and 2.93% for the non-HTG-AP group (P=0.175). Conclusion: The HTG-AP group had a longer LOS and higher pancreatitis severity compared to the non-HTG-AP group, despite the fact that all patients were managed with a standardized early medical management protocol. These findings suggest a need to improve risk stratification based on AP etiology and identify opportunities to improve management of HTG-AP.Table 1.: Differences in demographics and outcomes between patients with hypertriglyceridemia acute pancreatitis and acute pancreatitis from other etiologies.