Chronic Pancreatitis Is Characterized by Distinct Complication Clusters That Associate With Etiological Risk Factors

• DOI: 10.14309/ajg.0000000000000147
• Publication Date: 2019-02-12T21:08:31Z
• Authors: Søren S. Olesen; Camilla Nøjgaard; Jakob L. Poulsen; Stephan L. Haas; Miroslav Vujasinovic; Matthias Löhr; Björn Lindkvist; Louise Bexander; Antanas Gulbinas; Evangelos Kalaitz...; Mohamed Ebrahim; Friedemann Erchinger; Trond Engjom; Stine Roug; Srdan Novovic; Truls Hauge; Anne Waage; Johanna Laukkarinen; Mikael Parhiala; Aldis Pukitis; Imanta Ozola-Zālīte; Asbjørn M. Drewes
• Keywords: Etiology

OBJECTIVES: Chronic pancreatitis (CP) is characterized by several disease-related complications and multiple etiological risk factors. Past studies of associations between factors have mostly been limited to single or highly focused on etiologies. Using an objective data-driven approach (cluster analysis), we complication clusters their with in a large cohort patients CP. METHODS: This was multicenter, cross-sectional study including 1,071 CP from the Scandinavian Baltic countries. Complications were classified according M-ANNHEIM system, treelet transform used derive clusters. Cluster frequencies analyzed for association main (smoking alcohol). RESULTS: The mean age participants 57 years 66% men. Alcohol (55%) smoking (53%) most common seen combination 36% patients. analysis identified 3 distinct inflammation, fibrosis, pancreatic insufficiencies. An independent inflammatory alcoholic etiology (odds ratio [OR] 2.00 [95% CI [confidence interval], 1.38–2.90], P < 0.001), whereas associated fibrosis-related (OR 2.23 CI, 1.56–2.3.20], 0.001) insufficiencies 1.42 1.00–2.01], = 0.046). DISCUSSION: Three distinctive identified. Their differing indicate underlying disease mechanisms.