Metabolic Syndrome Is Associated With Worsened Clinical Outcomes in Individuals With Necrotizing Pancreatitis

GOALS: Evaluate the relationship between metabolic syndrome (MetS) and clinical outcomes in individuals with necrotizing pancreatitis (NP) and infected pancreatic necrosis (IPN). BACKGROUND: MetS affects a significant proportion of the global population and is associated with low-grade systemic inflammation and immune dysregulation. This has implications for several disease processes, but the impact of MetS on patients with NP is not well characterized. STUDY: A retrospective cohort study of patients admitted with NP at a single tertiary center was performed. MetS was defined as meeting any 3 of the following criteria: BMI ≥30 kg/m2, triglycerides ≥150 mg/dL, fasting glucose ≥110 mg/dL, blood pressure ≥130/85 mm Hg, and low HDL (<40 mg/dL men, <50 mg/dL women). The need for intensive care, hospital length of stay, development of organ failure, and mortality were compared in patients with NP with or without MetS. Secondary outcomes included the incidence of IPN. RESULTS: A total of 276 (154 MetS, 55.8%) patients were identified. Individuals with MetS more frequently required ICU-level care (38.3% vs. 17.2%; P<0.001) and longer length of stay (9.0 vs. 5.0 d; P=0.029). There was a higher risk of sepsis in those with MetS (27.5% vs. 15.6%; P=0.019), as well as respiratory failure (31.2% vs. 18%; P=0.013), renal failure (35.7% vs. 21.3%; P=0.009), and in-hospital mortality (17.5% vs. 8.2%; P=0.024). The incidence of IPN was higher in patients with MetS (39.6% vs. 23.0%; P=0.003). CONCLUSION: The presence of MetS in individuals with NP was associated with worsened outcomes, including increased incidence of IPN, sepsis, organ failure, ICU admission, and mortality during index hospitalization.