Six-fold increased risk of acute pancreatitis in alcohol-related liver disease compared to matched comparators: a population-based cohort study
Background and Aims Patients with alcohol-related liver disease (ALD) might be at increased risk of acute pancreatitis (AP), but large-scale data are lacking. Methods Population-based cohort study using data from the Swedish National Patient Register on 37,062 patients with ALD from 1969 to 2020. Pa...
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| Main Authors: | , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
February 2025
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| In: |
Journal of internal medicine
Year: 2025, Volume: 297, Issue: 2, Pages: 213-226 |
| ISSN: | 1365-2796 |
| DOI: | 10.1111/joim.20026 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1111/joim.20026 Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/joim.20026 
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| Author Notes: | Ana Dugic, Linnea Widman, J.-Matthias Löhr & Hannes Hagström |
| Summary: | Background and Aims Patients with alcohol-related liver disease (ALD) might be at increased risk of acute pancreatitis (AP), but large-scale data are lacking. Methods Population-based cohort study using data from the Swedish National Patient Register on 37,062 patients with ALD from 1969 to 2020. Patients were matched to ≤10 general population comparators (n = 352,931). We used logistic regression to estimate the risk of acute or chronic pancreatitis prior to ALD diagnosis and Cox regression to estimate rates for hospitalization for AP after ALD diagnosis. Results Median age at ALD diagnosis was 59 years; 72% were men, and 67% had cirrhosis at baseline. Overall, 7% had experienced pancreatitis before ALD diagnosis, resulting in 9-fold higher odds of pancreatitis compared to comparators. The 10-year cumulative incidence of hospitalization for AP was 2.7% (95%CI = 2.5-2.8) in ALD and 0.6% (95%CI = 0.58-0.63) in comparators, yielding an adjusted HR of 6.3 (95%CI = 5.8-6.9). Younger age, male sex, and diagnoses of alcohol use disorders and chronic obstructive pulmonary disease were independent risk factors for developing AP in ALD. Continued drinking after baseline was associated with a higher risk of AP (adjusted hazard ratio [aHR] 2.6, 95%CI = 2.29-2.85). Conclusions ALD is associated with 9-fold higher odds of prevalent pancreatitis compared to the general population. The hospitalization rate for AP following ALD diagnosis is 6-fold higher. About 10% of patients with ALD have or develop AP, suggesting that assessing history of pancreatitis and its sequelae might be relevant for patients with ALD. |
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| Item Description: | Zuerst veröffentlicht: 10. Dezember 2024 Gesehen am 14.03.2025 |
| Physical Description: | Online Resource |
| ISSN: | 1365-2796 |
| DOI: | 10.1111/joim.20026 |