title: Differences in Severity and Outcomes Between Hypertriglyceridemia and Alcohol-Induced Pancreatitis.
abstract: BACKGROUND
  Alcohol and hypertriglyceridemia (HTG) are among the most common causes of acute pancreatitis (AP) after gallstones. However, differences in severity at the time of presentation and outcomes have not been well-studied.
  
  
  OBJECTIVE
  The aim of this study is to assess the differences between severity at presentation and outcomes of AP of hypertriglyceridemic and alcoholic origins.
  
  
  METHODS
  A retrospective review of 177 patients who were discharged with diagnosis of AP was performed. Severity at presentation was identified by the presence of systemic inflammatory response syndrome, bedside index for severity in AP (BISAP) score, and Balthazar index. Outcomes were measured by the length of stay, intensive care unit care, surgical intervention, and mortality.
  
  
  RESULTS
  We found 147 patients with alcoholic pancreatitis and 30 patients with hypertriglyceridemic pancreatitis. A larger percentage of hypertriglyceridemic pancreatitis patients (23.33%) had a BISAP score of ≥2 compared to the alcoholic group (12.24%). Only 32.65% of the patients with alcoholic pancreatitis but 60% of the patients with hypertriglyceridemic pancreatitis had the presence of systemic inflammatory response syndrome (SIRS) at admission (P = 0.0067). There were 73.34% hypertriglyceridemic pancreatits patients and only 40.28% alcoholic pancreatitis patients with Balthazar index C or greater, suggesting a higher disease burden at admission for hypertriglyceridemic pancreatitis patients (P = 0.0047). There was a statistically significant difference in the relative number of hypertriglyceridemic and alcoholic pancreatitis patients receiving intensive care (P = 0.00030) and in receiving surgical interventions related to pancreatitis (P = 0.016).
  
  
  CONCLUSIONS
  Our study found that patients with hypertriglyceridemic pancreatitis have a greater severity of disease and they experience less favorable outcomes than patients with alcoholic pancreatitis.
authors.affiliation: Department of Internal Medicine, The Medical Center, Navicent Health and Mercer University School of Medicine, Macon, Georgia, USA.
authors.forename: Hemant
authors.initials: H
authors.lastname: Goyal
authors.affiliation: Department of Internal Medicine, The Medical Center, Navicent Health and Mercer University School of Medicine, Macon, Georgia, USA.
authors.forename: Betsy
authors.initials: B
authors.lastname: Smith
authors.affiliation: Department of Internal Medicine, The Medical Center, Navicent Health and Mercer University School of Medicine, Macon, Georgia, USA.
authors.forename: Chelsey
authors.initials: C
authors.lastname: Bayer
authors.affiliation: Department of Internal Medicine, The Medical Center, Navicent Health and Mercer University School of Medicine, Macon, Georgia, USA.
authors.forename: Carla
authors.initials: C
authors.lastname: Rutherford
authors.affiliation: Department of Internal Medicine, The Medical Center, Navicent Health and Mercer University School of Medicine, Macon, Georgia, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Shelnut
keywords: Alcoholic pancreatitis; hypertriglyceridemic pancreatitis; outcome; severity