Obesity Paradox in Acute Pancreatitis

Background and Aim Obesity is an established risk factor for cardiovascular diseases, some types of cancer and mortality in general population. It is also considered a risk factor for poor outcome in acute pancreatitis. However, a reverse association between obesity and mortality has been reported in certain populations such as elderly, congestive heart failure and obstructive pulmonary disease showing that obesity might be protective for mortality. Along this same line, we aimed to further analyze the relationship between obesity and all-cause in-hospital mortality in patients with acute pancreatitis. Methods A retrospective chart review of consecutive patients admitted with acute pancreatitis as the primary reason for discharge in Spain between January 1st 2005 and December 31st 2013 was performed. Patients with a diagnosis of obesity in the hospital discharge clinical report were identified. The in-hospital mortality rate of obese patients with acute pancreatitis was compared with their non-obese counterparts. Results The medical records of 55285 patients with acute pancreatitis were retrospectively analyzed, 4594 (8.3%) being obese. In-hospital global mortality risk was 5.1%. Obese patients with acute pancreatitis showed lower in-hospital mortality risk (OR 0.62 IC 95% 0.53-0.73) than those non-obese. After adjusting for possible confounding factors, obese patients showed a significantly lower risk of death compared with non-obese subjects (OR 0.72 CI95% 0.61 -0.86). Conclusions The results of this report show a reverse association between obesity and all-cause in-hospital mortality among patients with acute pancreatitis.


Raquel Barba, Asunción Gonzálvez-Gasch, Jesús Canora, Susana Plaza, Javier Marco, Miguel Yebra, Antonio Zapatero

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