Fatty pancreas was associated with a higher acute pancreatitis Systemic Inflammatory Response Syndrome score at hospital admission

BACKGROUND: Pancreatic fat infiltration was shown to be linked with acute pancreatitis and probably its severity. These interesting findings merit more investigation to elucidate the effect of fatty pancreas on acute pancreatitis severity. METHODS: We performed a retrospective study of patients hospitalized with documented acute pancreatitis. Pancreatic fat was determined according to pancreas attenuation on computed tomography. Patients were divided into two groups, with and without fatty pancreas. The Systemic Inflammatory Response Syndrome (SIRS) score was compared. RESULTS: Overall, 409 patients were hospitalized with acute pancreatitis. Among them, 48 patients had fatty pancreas (group A), vs. 361 patients who did not (group B). The mean ± SD age in group A was 54.6 ± 21.3, vs. 57.6 ± 16.8 in group B ( P = 0.51). Patients in group A, had a significantly higher rate of fatty liver, as compared to group B (85.4% vs. 35.5%, P < 0.001). There was no significant difference in the medical history among the two groups. Fatty pancreas was associated with more severe acute pancreatitis as assessed by SIRS score at admission. The mean ± SD of SIRS score was significantly higher in group A (0.92 ± 0.87), as compared to 0.59 ± 0.74 in group B ( P = 0.009). Positive SIRS score was present in a significantly higher proportion of patients with fatty pancreas (25%), as compared to only 11.4% in group B ( P = 0.02). CONCLUSION: The occurrence of acute pancreatitis with higher SIRS score was significantly associated with fatty pancreas. Fatty pancreas may represent a predictor of acute pancreatitis severity.