FEM de Rijk, NJ Sissingh, TT Boel, HC Timmerhuis, MJP de Jong, HS Pauw, CL van Veldhuisen, ND Hallensleben, MPGF Anten, MA Brink, WL Curvers, P van Duijvendijk, WL Hazen, SD Kuiken, AC Poen, R Quispel, TEH Römkens, BWM Spanier, ACITL Tan, FP Vleggaar, AMCJ Voorburg, BJM Witteman, U Ahmed Ali, Y Issa, SAW Bouwense, RP Voermans, RLJ van Wanrooij, MWJ Stommel, JE van Hooft, PJ de Jonge, H van Goor, MA Boermeester, MG Besselink, MJ Bruno, RC Verdonk, HC van Santvoort,

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

  • Gastroenterology
  • Hepatology

AbstractBackground and AimMore 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.MethodsA 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.ResultsOverall, 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.ConclusionDisease 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.

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