Much of the late morbidity and mortality of acute pancreatitis is attributed to complications of pancreatic necrosis.
Early diagnosis of pancreatic necrosis in high-risk patients is critical to management.
Hemoconcentration is one risk factor for pancreatic necrosis, but additional risk factors are likely implicated.
Dr David Whitcomb and colleagues from Pennsylvania evaluated a series of preselected clinical factors in a prospectively collected cohort with acute pancreatitis.
The research team identified risk factors for pancreatic necrosis.
The team also verified the relative risk of any newly identified factor by retrospective analysis of a large patient cohort.
|14% of subjects developed pancreatic necrosis|
|American Journal of Gastroenterology|
During Phase 1, the team prospectively ascertained 102 acute pancreatitis patients.
Of these, 77 underwent contrast-enhanced computerized tomography.
The researchers found that 14% of subjects developed pancreatic necrosis.
Binary logistic regression was performed to identify any clinical factors associated with pancreatic necrosis.
In Phase 2, the team electronically reviewed 1474 anonymized patients admitted to the hospital with a diagnosis of acute pancreatitis.
Of these, the researchers identified 359 subjects with acute pancreatitis and contrast-enhanced computerized tomography.
The team found that 21% of these patients exhibited contrast-enhanced computerized tomography evidence of pancreatic necrosis.
The associations found in the Phase 1 group were compared with Phase 2 by logistic regression analysis.
In Phase 1, the team identified only chronic alcohol consumption as a significant new risk factor for the development of pancreatic necrosis.
In Phase 2, the researchers verified that excessive alcohol consumption was a significant risk factor for pancreatic necrosis.
Dr Whitcomb's team concludes, “Chronic alcohol consumption seems to constitute a strong risk factor for pancreatic necrosis.”