Jaleh Hassanloo1, Sarah Béland-Bonenfant2, Martine Paquette3, Alexis Baass4, Sophie Bernard5. 1. Division of Endocrinology and Metabolism, McGill University Health Centre (MUHC), Montreal Québec, Canada (Hassanloo). 2. Department of Medicine, Division of Endocrinology, University of Montreal, Montreal Québec, Canada (Béland-Bonenfant, Bernard). 3. Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montreal Québec, Canada (Paquette, Baass, Bernard). 4. Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montreal Québec, Canada (Paquette, Baass, Bernard); Department of Medicine, Divisions of Experimental Medicine and Medical Biochemistry, McGill University, Montreal Québec, Canada (Baass). 5. Department of Medicine, Division of Endocrinology, University of Montreal, Montreal Québec, Canada (Béland-Bonenfant, Bernard); Genetic Dyslipidemias Clinic of the Montreal Clinical Research Institute, Montreal Québec, Canada (Paquette, Baass, Bernard); Research Centre of the Centre Hospitalier Universitaire de Montréal (CRCHUM), Montreal, Québec, Canada (Bernard). Electronic address: sophie.bernard@ircm.qc.ca.
Abstract
BACKGROUND: Hypertriglyceridemia (HTG) is known as the third most common cause of acute pancreatitis (AP). OBJECTIVE: To study the prevalence and outcomes of HTG-AP as well as the quality of the follow-up post HTG-AP hospitalization in Canada. METHODS: This retrospective multicenter study was performed in patients admitted with AP (ICD 10 code K85) in quaternary care hospitals between 2012 and 2018. For every case of HTG-AP (TG ≥ 5.6 mmol/L on admission), two controls of biliary-AP were selected and matched for sex and age at the time of admission. RESULTS: Out of 1490 admitted AP patients, 40 (3%) had HTG-AP. The average TG concentration was higher in patients admitted to the ICU compared to those who were not (27.34 mmol/L vs 13.02 mmol/L). Compared to biliary-AP group, the HTG-AP patients had more frequent severe Balthazar grade (45% vs 25%) with longer duration of hospitalisation (nine versus five days) and more frequent ICU admission (38% vs 8%). Furthermore, only 35% of HTG-AP patients were referred to specialized clinics and 42.5% were left with no follow-up. Only 17% of newly discovered HTG-AP patients were started on fibrate at discharge. CONCLUSION: In comparison to biliary-AP, HTG-AP patients had a worse clinical course of pancreatitis. Furthermore, the quality of the follow-up post HTG-AP hospitalization was suboptimal. This could be explained by of the lack of knowledge of health care providers concerning the proper diagnosis and management of chylomicronemia syndromes, leading to this condition to be frequently missed or underdiagnosed.
BACKGROUND: Hypertriglyceridemia (HTG) is known as the third most common cause of acute pancreatitis (AP). OBJECTIVE: To study the prevalence and outcomes of HTG-AP as well as the quality of the follow-up post HTG-AP hospitalization in Canada. METHODS: This retrospective multicenter study was performed in patients admitted with AP (ICD 10 code K85) in quaternary care hospitals between 2012 and 2018. For every case of HTG-AP (TG ≥ 5.6 mmol/L on admission), two controls of biliary-AP were selected and matched for sex and age at the time of admission. RESULTS: Out of 1490 admitted AP patients, 40 (3%) had HTG-AP. The average TG concentration was higher in patients admitted to the ICU compared to those who were not (27.34 mmol/L vs 13.02 mmol/L). Compared to biliary-AP group, the HTG-AP patients had more frequent severe Balthazar grade (45% vs 25%) with longer duration of hospitalisation (nine versus five days) and more frequent ICU admission (38% vs 8%). Furthermore, only 35% of HTG-AP patients were referred to specialized clinics and 42.5% were left with no follow-up. Only 17% of newly discovered HTG-AP patients were started on fibrate at discharge. CONCLUSION: In comparison to biliary-AP, HTG-AP patients had a worse clinical course of pancreatitis. Furthermore, the quality of the follow-up post HTG-AP hospitalization was suboptimal. This could be explained by of the lack of knowledge of health care providers concerning the proper diagnosis and management of chylomicronemia syndromes, leading to this condition to be frequently missed or underdiagnosed.