Clinical features of acute pancreatitis of different etiologies

Objective To investigate the clinical features of acute pancreatitis ( AP) of different etiologies. Methods A retrospective analysis was performed for the clinical data of 150 patients with AP who were admitted to Department of Gastroenterology, Guangdong General Hospital, from January 2014 to December 2015, and among these patients, 97 had biliary pancreatitis, 32 had hyperlipidemic pancreatitis, and 21 had alcoholic pancreatitis. The three groups were compared in terms of sex, age, comorbidities, laboratory examination, distribution of severity, complications, related scores, and length of hospital stay. An analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test was used for further comparison between any two groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test was used for further comparison between any two groups. The chi-square test or Fisher' s exact test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of ranked data between groups. Results The biliary pancreatitis group had a significantly older age of onset than the other two groups, and most of the patients in this group were female, while most of the patients in the other two groups were male ( all P < 0. 05) . The biliary pancreatitis group had a significantly higher proportion of patients with heart disease or hypertension, while the hyperlipidemic pancreatitis group had a significantly higher proportion of patients with diabetes ( all P < 0. 05) . The biliary pancreatitis group had significantly higher levels of blood amylase, alanine aminotransferase, and aspartate aminotransferase and a significantly lower level of C-reaction protein on admission and at 72 hours after admission, compared with the other two groups ( all P < 0. 05) . The hyperlipidemic pancreatitis group had significantly higher levels of blood glucose, blood lipids ( triglyceride and cholesterol) , and glycosylated hemoglobin ( all P < 0. 05) . There was no significant difference in distribution of severity between the three groups ( P > 0. 05) . The biliary pancreatitis group had significantly lower incidence rate of acute fluid collection and MCTSI score than the other two groups ( both P < 0. 05) , and the alcoholic pancreatitis group had a significantly higher incidence rate of systemic infection than the other two groups ( P < 0. 05) . There was no significant difference in the length of hospital stay between the three groups ( P > 0. 05) . Conclusion The difference in the etiology of AP does not affect disease severity and prognosis. The etiology of AP can be identified as early as possible with reference to the features of demographics, comorbidities, and laboratory examination, and therefore, proper treatment can be given to improve patients' prognosis.