To Study the Effect of On-Admission Serum Triglyceride Levels on the Severity and Outcome of Patients with Acute Pancreatitis

Abstract

Importance: Acute pancreatitis (AP) is a potentially severe inflammatory condition of the pancreas with variable clinical presentations and significant morbidity and mortality. Early identification of severity predictors is crucial for optimizing patient management and outcomes.

Objective: To evaluate the clinical features of acute pancreatitis and assess the impact of on-admission serum triglyceride levels on disease severity and outcomes.

Design: It is a prospective hospital-based observational study conducted from November 2021 to October 2022 in the Department of General Surgery, Government Medical College Hospital, Jammu, India.

Setting: It included a total of 115 patients admitted with acute pancreatitis within 72 hours of symptom onset, meeting diagnostic criteria and consenting to participate. Patients with prior acute pancreatitis or significant comorbidities were excluded. Clinical, biochemical, and imaging assessment alongside serum triglyceride measurement was done at admission and patients were stratified into two groups based on triglyceride levels (<200 mg/dL vs. ≥200 mg/dL). The main outcomes were severity of acute pancreatitis assessed by Ranson and APACHE II scores, presence of complications including systemic inflammatory response syndrome (SIRS), pleural effusion, acute respiratory distress syndrome (ARDS), and hospital course parameters.

Results: Of the 115 patients, 82 had triglycerides <200 mg/dL (Group I) and 33 had triglycerides ≥200 mg/dL (Group II). Group II patients were younger and predominately male. Severity scores were significantly higher in Group II (mean APACHE II 5.33 vs 4.21, p=0.005; Ranson score 1.75 vs 1.24, p=0.017). Complications including pleural effusion (36.36% vs 17.07%, p=0.02), ARDS (12.12% vs 1.21%, p=0.02), and SIRS (33.33% vs 9.7%, p=0.002) were significantly more frequent in Group II. No significant difference in hospital stay length or local complications was observed.

Conclusion: Elevated serum triglyceride levels (≥200 mg/dL) at admission are associated with increased severity and systemic complications in acute pancreatitis. Early measurement of triglycerides can serve as a valuable prognostic marker to identify high-risk patients warranting intensified monitoring and management.