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

Author

de Rijk, F. E.M., Sissingh, N. J., Boel, T. T., Timmerhuis, H. C., de Jong, M. J.P., Pauw, H. S., van Veldhuisen, C. L., Hallensleben, N. D., Anten, M. P.G.F., Brink, M. A., Curvers, W. L., van Duijvendijk, P., Hazen, W. L., Kuiken, S. D., Poen, A. C., Quispel, R., Römkens, 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. Ahmed, Issa, Y., Bouwense, S. A.W., Voermans, R. P., van Wanrooij, R. L.J., Stommel, M. W.J., van Hooft, J. E., de Jonge, P. J., van Goor, H., Boermeester, M. A., Besselink, M. G., Bruno, M. J., Verdonk, R. C., van Santvoort, H. C., de Rijk, F. E.M., Sissingh, N. J., Boel, T. T., Timmerhuis, H. C., de Jong, M. J.P., Pauw, H. S., van Veldhuisen, C. L., Hallensleben, N. D., Anten, M. P.G.F., Brink, M. A., Curvers, W. L., van Duijvendijk, P., Hazen, W. L., Kuiken, S. D., Poen, A. C., Quispel, R., Römkens, 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. Ahmed, Issa, Y., Bouwense, S. A.W., Voermans, R. P., van Wanrooij, R. L.J., Stommel, M. W.J., van Hooft, J. E., de Jonge, P. J., van Goor, H., Boermeester, M. A., Besselink, M. G., Bruno, M. J., Verdonk, R. C., and van Santvoort, H. C.

Abstract

Background and Aim: More 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. Methods: A 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. Results: Overall, 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. Conclusion: Disease 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.

Published
2024

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

Author

de Rijk F, Sissingh NJ, Boel TT, Timmerhuis HC, de Jong M, Pauw HS, van Veldhuisen CL, Hallensleben ND, Anten M, Brink MA, Curvers WL, van Duijvendijk P, Hazen WL, Kuiken SD, Poen AC, Quispel R, Römkens T, Spanier B, Tan A, Vleggaar FP, Voorburg A, Witteman B, Ali UA, Issa Y, Bouwense S, Voermans RP, van Wanrooij R, Stommel M, van Hooft JE, de Jonge PJ, van Goor H, Boermeester MA, Besselink MG, Bruno MJ, Verdonk RC, and van Santvoort HC

Subjects
Humans, Male, Acute Disease, Disease Progression, Follow-Up Studies, Neoplasm Recurrence, Local complications, Prospective Studies, Recurrence, Risk Factors, Pancreatic Diseases complications, Pancreatic Neoplasms etiology, Pancreatic Neoplasms complications, Pancreatitis, Chronic complications, Pancreatitis, Chronic epidemiology
Abstract

Background and Aim: More 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., Methods: A 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., Results: Overall, 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., Conclusion: Disease 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., (© 2024 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Published
2024
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