Key result
In patients with very severe hypertriglyceridemia-induced acute pancreatitis, insulin and heparin therapy showed no significant difference in the rate of triglyceride reduction compared to plasma exchange (p=0.532), but was associated with significantly lower hospital costs.
Why the study?
Prognosis in hypertriglyceridemia-induced acute pancreatitis may vary with baseline triglyceride levels, suggesting a need for stratified treatment approaches.
Does a stratified management approach using insulin/heparin or NPO reduce costs while maintaining similar prognosis compared to more intensive therapies in patients with hypertriglyceridemia-induced acute pancreatitis?
Cohort (n=171)
No
Does a stratified management approach using insulin/heparin or NPO reduce costs while maintaining similar prognosis compared to more intensive therapies in patients with hypertriglyceridemia-induced acute pancreatitis?
p-value: p=0.532
A stratified, less intensive management approach for hypertriglyceridemia-induced acute pancreatitis provides similar clinical efficacy to more intensive therapies while significantly reducing hospital costs.
BACKGROUND: Effective management of hypertriglyceridemia is crucial in the treatment of hypertriglyceridemia-induced acute pancreatitis (HTG-AP). The prognosis of HTG-AP may vary with different serum triglyceride levels, suggesting the need for stratified treatment approaches. In this study, we investigated hypertriglyceridemia management in HTG-AP patients and the optimal strategy. METHODS: Patients with HTG-AP from October 2020 to October 2022 were included in the study. Propensity score matching was used to balance the bias and confounding variables. A mixed-effects model was used to analyse the decreasing tendency of triglycerides. RESULTS: A total of 171 patients who were diagnosed with HTG-AP were enrolled in this cohort. Patients with very severe serum triglycerides (> 22.6mmol/L) had a higher proportion of severe acute pancreatitis (p < 0.05) than patients with severe hypertriglyceridemia (11.3-22.6 mmol/L). For the very severe hypertriglyceridemia group, no significant differences in prognosis were noted between the insulin and heparin group and the plasma exchange group. The cost of the insulin and heparin group was significantly lower than that of the plasma exchange group (p < 0.01). In patients with severe hypertriglyceridemia, no significant differences in prognosis were noted between the nothing-by-mouth (NPO) group and the insulin and heparin group. Compared with the insulin and heparin group, the NPO group had lower hospital costs (p < 0.05). CONCLUSION: HTG-AP patients with very severe hypertriglyceridemia may be treated safely and effectively with insulin and heparin, potentially offering a more cost-effective treatment approach. Similarly, patients with severe hypertriglyceridemia might benefit from treatment involving NPO, which may be associated with lower costs. Further studies are needed to validate these findings in diverse populations and through long-term follow-up.
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Tan et al. (2025) conducted a cohort in Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) (n=171). Insulin and heparin vs. Plasma exchange was evaluated on Decreasing trend in daily serum triglyceride levels (p=0.532). In patients with very severe hypertriglyceridemia-induced acute pancreatitis, insulin and heparin therapy showed no significant difference in the rate of triglyceride reduction compared to plasma exchange (p=0.532), but was associated with significantly lower hospital costs.
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