Chronic Alcohol Consumption Is a Major Risk Factor for Pancreatic Necrosis in Acute Pancreatitis

Authors: Papachristou, Georgios I.¹; Papachristou, Dionysios J.²; Morinville, Veronique D.¹; Slivka, Adam¹; Whitcomb, David C.

Source: The American Journal of Gastroenterology, Volume 101, Number 11, November 2006 , pp. 2605-2610(6)

Publisher: Wiley-Blackwell

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Abstract:

BACKGROUND: Much of the late morbidity and mortality of acute pancreatitis (AP) is attributed to complications of pancreatic necrosis (PNEC). Early diagnosis of PNEC in high-risk patients is critical to management. Hemoconcentration is one risk factor for PNEC, but additional risk factors are likely implicated.

AIMS: (1) To evaluate a series of preselected clinical factors in a prospectively collected cohort with AP to identify risk factors for PNEC and (2) to verify the relative risk of any newly identified factor(s) by retrospective analysis of a large patient cohort.

METHODS: Phase I: 102 AP patients were prospectively ascertained, of which 77 (mean age 49 yr; 35 women, 42 men) underwent contrast-enhanced computerized tomography (CECT) and were studied. Eleven subjects developed PNEC (14%). Binary logistic regression was performed to identify any clinical factors associated with PNEC. Phase II: 1,474 anonymized patients admitted to the hospital with a diagnosis of AP were electronically reviewed to identify 359 subjects (mean age 54 yr; 157 women, 202 men) with AP and CECT. Seventy-six of these patients (21%) exhibited CECT evidence of PNEC. The associations found in the Phase I group were compared with Phase II by logistic regression analysis.

RESULTS: In Phase I, only chronic alcohol consumption was identified as a significant new risk factor for the development of PNEC (6/19 vs 5/58, p= 0.02, OR 4.8, CI 1.27-18.2). In Phase II, it was verified that excessive alcohol consumption was a significant risk factor for PNEC (18/52 vs 58/307, p= 0.012, OR 2.27, CI 1.19-4.30).

CONCLUSION: Chronic alcohol consumption seems to constitute a strong risk factor for PNEC.

(Am J Gastroenterol 2006;101:2605-2610)

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1572-0241.2006.00795.x

Affiliations: 1: Medicine 2: Pathology

Publication date: 2006-11-01