S42 Epidemiology and Outcomes of Sarcopenia in Patients With Chronic Pancreatitis: A Nationwide Population-Based Study

Abstract

Introduction: Patients with chronic pancreatitis (CP) frequently have more advanced malnutrition. Various factors such as pain, alcoholism, malabsorption, and maldigestion from pancreatic exocrine insufficiency render these patients at increased risk for sarcopenia. This work intends to assess the prevalence of sarcopenia in CP and its outcomes. Methods: We reviewed data from a large multi-center database (Explorys IBM) aggregated from 26 large nationwide healthcare systems. Using systemized nomenclature of clinical medical terms (SNOMED CT), CP patients with and without sarcopenia were identified. Additionally, demographic data, including age, sex, race, ethnicity, smoking habits, and outcomes of CP, were obtained. We calculated the odds ratio (OR) using a univariate analysis model. Results: Among 69 million adult patients in the database, 106,540 patients with CP were identified, and 31.3% of these patients were found to have sarcopenia. Patients with history of sarcopenia were more likely to be elderly ( >65-years-old) (OR: 1.26; 95% confidence interval [CI] 1.23-1.29; P < 0.0001), female (OR, 1.11; 95% CI, 1.08–1.13; P < 0.0001), Caucasian (OR, 1.09; 95% CI, 1.06–1.11; P < 0.0001), and smokers (OR 1.53; 95% CI 1.49-1.57, P < 0.0001). CP patients with sarcopenia had increased prevalence of primary pancreatic malignancy (OR, 1.47; 95% CI, 1.4–1.55; P < 0.0001), pancreatic pseudocyst (OR, 1.41; 95% CI, 1.36–1.47; P < 0.0001), exocrine pancreatic insufficiency (OR, 1.93; 95% CI, 1.4–2.65; P = 0.0001), pancreatic malabsorption (OR, 1.72; 95 CI, 1.51-1.97; P < 0.0001), venous thrombosis (OR, 1.57; 95% CI, 1.53–1.62; P < 0.0001), and gastrointestinal hemorrhage (OR, 2.69; 95% CI, 2.63–2.75; P < 0.0001) (Table). Conclusion: This is the largest study to characterize the epidemiology and outcomes of chronic pancreatitis patients with sarcopenia. Our data indicate that sarcopenia is associated with an increased risk of CP complications and may be an important prognostic factor in CP. Table 1. - Comparison of baseline characteristics and outcomes of CP with and without sarcopenia CP with sarcopenia (n=48,220) CP without sarcopenia (n=106,050) OR (CI) P-value Demographics >65 21,970 (46%) 42,250 (40%) 1.26 (1.23-1.29) < 0.0001 Female 24,410 (51%) 50,970 (48%) 1.11 (1.08-1.13) < 0.0001 Caucasian 33,810 (70%) 72,500 (68%) 1.09 (1.06-1.11) < 0.0001 Smoking 31,120 (77%) 72,700 (69%) 1.53 (1.49-1.57) < 0.0001 CP outcomes Exocrine pancreatic insufficiency 70 (0.2%) 80 (0.1%) 1.93 (1.4-2.65) 0.0001 Pancreatic malabsorption 390 (1%) 500 (0.5%) 1.72 (1.51-1.97) < 0.0001 Pancreatic Pseudocyst 4,640 (10%) 7,440 (7%) 1.41 (1.36 -1.47) < 0.0001 Primary pancreatic malignancy 2,400 (5%) 3,640 (3%) 1.47 (1.4-1.55) < 0.0001 Gastrointestinal hemorrhage 15,540 (32%) 24,050 (23%) 2.69 (2.63-2.75) < 0.0001 Venous thrombosis 10,350 (22%) 15,690 (15%) 1.57 (1.53-1.62) < 0.0001