Pancreatic necrosis and severity are independent risk factors for pancreatic endocrine insufficiency after acute pancreatitis: A long-term follow-up study

Table 1 Baseline clinical characteristics of enrolled acute pancreatitis patients

	All patients (n = 361)	Normal glucose group (n = 211)	Dysglycemia group (n = 150)	P value
Age	48.63 ± 13.36	49.25 ± 13.83	47.75 ± 12.66	0.2921
Sex, n (%)
Male	201 (55.7)	117 (55.5)	84 (56)	0.9172
Female	160 (44.3)	94 (44.5)	66 (44)
BMI	23.36 ± 3.98	23.37 ± 4.039	23.36 ± 3.91	0.7711
APACHE II score	8.46 ± 3.80	8.18 ± 3.52	8.87 ± 4.14	0.5081
Etiology, n (%)
Biliary	166 (46)	103 (48.8)	63 (42)	0.4732
HTG	130 (36)	69 (32.7)	61 (40.7)
Alcoholic	52 (14.4)	31 (14.7)	21 (14)
Others	13 (3.6)	8 (3.8)	5 (3.3)
Severity of AP
Mild	47 (13.0)	41 (19.4)	6 (4.0)	0.0012
Moderate	199 (55.1)	115 (54.5)	84 (56.0)
Severe	115 (31.9)	55 (26.1)	60 (40.0)
Organ failure
Yes	137 (38.0)	53 (25.1)	84 (56.0)	0.0012
No	224 (62.0)	158 (74.9)	66 (44.0)
Pancreatic necrosis
Yes	152 (42.1)	34 (16.1)	118 (78.7)	0.0012
No	209 (57.9)	177 (83.9)	32 (21.3)
Debridement of necrosis (minimally invasive and/or ON)
Yes	95 (26.3)	25 (11.8)	70 (46.7)	0.0012
No	266 (73.7)	186 (88.2)	80 (53.3)
History of smoking
Yes	81 (22.4)	46 (21.8)	35 (23.3)	0.7312
No	280 (77.6)	165 (78.2)	115 (76.7)
History of drinking
Yes	81 (22.4)	68 (32.2)	13 (8.6)	0.7312
No	280 (77.6)	143 (67.8)	137 (91.4)
Time interval (mo)	24.04 ± 23.67	18.73 ± 19.10	31.53 ± 27.27	0.0011

¹t test, comparison between normal glucose group and dysglycemia group.

²χ² test, comparison between training group and validation group. BMI: Body mass index; APACHE II: Acute physiology and chronic health evaluation II; HTG: Hypertriglyceridemia; AP: Acute pancreatitis; ON: Operative necrosectomy.

Table 2 Clinical characteristics of pancreatic necrosis, n (%)

Variable	All patients	Normal glucose group	Dysglycemna group
Pancreatic necrosis	152 (100)	34 (58.4)	118 (41.6)
Part of pancreatic necrosis
Head of pancreas	23 (15.1)	3 (8.8)	20 (16.9)
Body of pancreas	29 (19.0)	6 (17.6)	23 (19.4)
Tail of pancreas	79 (51.3)	22 (64.8)	57 (48.3)
Whole pancreas	21 (13.8)	3 (8.8)	18 (15.2)
Area of pancreatic necrosis
30%	42 (27.6)	27 (79.4)	15 (12.7)
30%-50%	54 (35.6)	3 (8.8)	51 (43.2)
> 50%	56 (36.8)	4 (11.8)	52 (44.1)

Table 3 Univariate and multivariate Cox regression analyses of prognostic factors for pancreatic endocrine insufficiency after acute pancreatitis onset

Variable	Univariate analysis		Multivariate analysis
	HR (95%CI)	P value	HR (95%CI)	P value
Age	0.987 (0.966-1.008)	0.784
Sex
Male	Reference
Female	0.856 (0.618-1.184)	0.348
BMI	1.026 (0.993-1.060)	0.125
APACHE II	1.023 (0.980-1.068)	0.296
Etiology
Biliary	Reference
HTG	1.417 (0.995-2.017)	0.053
Alcoholic	0.928 (0.565-1.527)	0.770
Others	1.578 (0.626-3.975)	0.333
Severity of AP
Mild	Reference		Reference
Moderate	4.400 (1.920-10.088)	0.001	3.489 (1.501-8.111)	0.004
Severe	3.929 (1.695-9.103)	0.001	2.529 (1.046-6.115)	0.039
Organ failure
No	Reference		Reference
Yes	1.163 (1.182-2.259)	0.003	1.004 (0.695-1.452)	0.982
Pancreatic necrosis
No	Reference		Reference
Yes	3.287 (2.215-4.879)	0.001	4.152 (2.580-6.684)	0.001
Part of pancreatic necrosis
Head of pancreas	Reference		Reference
Body of pancreas	4.905 (2.864-8.400)	0.001	0.775 (0.388-1.550)	0.470
Tail of pancreas	2.435 (1.561-3.801)	0.001	6.433 (0.396-1.722)	0.609
Whole pancreas	4.448 (2.486-7.959)	0.001	0.675 (0.369-1.232)	0.200
Area of pancreatic necrosis
30%	Reference		Reference
30%–50%	3.988 (2.557-6.220)	0.001	6.433 (2.919-14.180)	0.001
> 50%	4,144 (2.661-6.456)	0.001	8.093 (3.867-16.936)	0.001
Debridement of necrosis (minimally invasive and/or ON)
No	Reference		Reference
Yes	1.451 (1.045-2.014)	0.026	0.683 (0.463-1.007)	0.054
History of smoking
No	Reference
Yes	1.276 (0.872-1.868)	0.209
History of drinking
No	Reference
Yes	1.276 (0.872-1.868)	0.209

BMI: Body mass index; APACHE II: Acute physiology and chronic health evaluation II; AP: Acute pancreatitis; HTG: Hypertriglyceridemia; ON: Operative necrosectomy.