Visceral Adiposity Predicts Severity of Acute Pancreatitis
The aim of this study was to determine the association of visceral adiposity with severe outcomes in acute pancreatitis (AP).Methods
This retrospective study included consecutive patients with AP admitted to a tertiary care hospital between January 2010 and January 2015 who underwent a computed tomography scan. The visceral adipose tissue (VAT) volume was estimated using the method of Linder and colleagues. Multivariable logistic regression analysis was conducted to assess VAT as a predictor of severe AP compared with other validated predictors of severity.Results
Five hundred and seventy four patients were admitted during the study period, of which 252 had a computed tomography scan available. Patients with severe AP had a larger VAT area compared with those with mild or moderate AP (mean: 184.9 cm2 vs 79.9 cm2, P = 0.006). Patients who developed multisystem organ failure or had acute necrotic collections had a larger VAT area than those who did not (150.6 cm2 vs 91.0 cm2, P = 0.004 and 174.0 cm2 vs 91.9 cm2, P = 0.003, respectively). Visceral adipose tissue area demonstrated superior discrimination of severe AP compared with other severity predictors.Conclusions
Increased VAT area is a strong predictor of severe pancreatitis, necrosis, and multisystem organ failure.