Obese patients appear to be at risk for complications of acute pancreatitis.
APACHE-O score has been suggested to improve APACHE-II accuracy in predicting severe outcome in acute pancreatitis.
Dr Georgios Papachristoua and colleagues from Pittsburgh determined if APACHE-O adds any predictive value to APACHE-II score.
The research team tested the hypothesis that obese patients are at increased risk of severe acute pancreatitis because of a more intense inflammatory response to pancreatic injury.
The researchers prospectively studied 102 acute pancreatitis patients.
Using a body mass index above 30, 28% of the subjects were obese.
The team identified 19 patients that developed organ dysfunction and were classified as severe acute pancreatitis.
Receiver-operating curves for prediction of severe acute pancreatitis were calculated using admission APACHE-II and APACHE-O scores.
|Obesity amplifyies the immune response to injury|
The researchers performed binary logistic regression to assess if obesity is a risk for severe acute pancreatitis.
The team also determined the clinical factors associated with severe disease.
Serum levels of interleukin-6, monocyte chemoattractant protein-1, C-reactive protein as well as Ranson's scores were compared between obese and non-obese patients.
The team found that admission APACHE-O and APACHE-II showed similar accuracy in predicting severe outcome.
Body mass index was identified as a significant risk for severe acute pancreatitis and mortality.
The researchers noted that C-reactive protein levels were significantly higher in obese acute pancreatitis patients as well as Ranson's score.
Interleukin-6 and monocyte chemoattractant protein-1 levels were higher in obese patients but did not reach statistical significance.
Dr Papachristoua's team concludes, “Obesity is an independent risk for severe acute pancreatitis.”
“Admission APACHE-O score is not more accurate than APACHE-II.”
“Our study results suggest that obesity increases the severity of acute pancreatitis by amplifying the immune response to injury.”