Association of Fatty Liver with Severity and Clinical Outcomes in Patients with Acute Pancreatitis: A Prospective Study from a Tertiary Care Center in South India

Abstract

Background and Objectives: Acute pancreatitis (AP) may be mild or severe, and early prognostication of severity is considered to be important. Fatty liver (FL) is a widely prevalent clinicopathologic entity that represents underlying chronic, systemic inflammation. This study was undertaken to determine whether the presence of FL was associated with severity outcomes of AP. Methods: Consecutive patients hospitalized with a diagnosis of AP were included. AP severity was graded as per the 2012 Revised Atlanta classification. FL was defined as a liver-to-spleen attenuation ratio <1 on noncontrast computed tomography of the abdomen. AP severity, length of hospital stay (LOHS), requirement of intensive care unit (ICU) admission, local complications, organ failure (OF), and mortality were compared between the FL and non-FL groups. Results: Of 88 recruited patients, 47.7% had FL. AP severity was significantly higher in the FL group (P < 0.05). The prevalence of local complications (52.4% vs. 19.6%, P < 0.05), OF (35.7% vs. 13%, P < 0.05), ICU admission (30.9% vs. 8.7%, P < 0.05) and mortality (11.9% vs. 0, P = 0.016) was significantly higher in patients with FL compared to non-FL. LOHS (11.6 ± 2.9 vs. 4.7 ± 0.3 days, mean ± standard deviation) was significantly higher in FL patients. Logistic regression analysis identified FL as a risk factor, independent of age and gender, severity, local complications, and OF in AP. Conclusion: FL is significantly associated with morbidity and mortality in AP. It can serve as a potential prognostic marker for integration into models for the prediction of AP severity.