P1049 - Systemic Sclerosis Patients Have a Higher Risk of Developing Acute Pancreatitis: A Nationwide Population-Based Study

Monday, October 25, 2021

10:30 AM – 4:15 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Ahmed Eltelbany, MD, MPH

Cleveland Clinic Foundation
Cleveland, OH, United States

Ahmed Eltelbany, MD, MPH¹, Osama Hamid, MD¹, Abdul Mohammed, MD², George Khoudari, MD¹, Prashanthi N. Thota, MD¹, Madhusudan Sanaka, MD¹
¹Cleveland Clinic Foundation, Cleveland, OH; ²MetroHealth Medical Center, Cleveland, OH

Introduction: Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibroproliferative alterations of the microvasculature leading to fibrosis and loss of function of the skin and internal organs. Gastrointestinal manifestations of SSc are the most commonly encountered complications of the disease affecting nearly 90% of the SSc population. A few cases of acute pancreatitis (AP) in SSc have been described, however, the risk of AP among SSc patients is not known. We sought to investigate the risk and predictors of AP among SSc patients.

Methods: We used a commercial database (Explorys Inc, Cleveland, OH) which includes electronic health record data from 26 major integrated US healthcare systems. Based on Systematized Nomenclature Of Medicine – Clinical Terms (SNOMED-CT), we identified all patients (age >18 years) who were diagnosed with SSc another cohort of those who developed AP. Logistic regression analysis was performed for AP in 2 groups of patients: those with SSc and those without SSc.

Results: Of the 62,720,250 individuals in the database from 2010 to 2019, we identified 32,920 patients with SSc and 366,050 patients with AP, of whom 670 (2%) carried both diagnoses. Statistically significant differences were found in 7 demographic and baseline characteristics: Male sex, alcohol abuse, biliary stones, smoking, hypertriglyceridemia, hypercalcemia and obesity (table1). Multivariate logistic regression analysis showed that patients in the SSc group had 3.54 times higher odds (odds ratio 3.54, 95% Confidence Interval 3.28-3.38, P = 0.000) of developing AP.

Discussion: This is the largest individual study investigating prevalence of AP in patients with SSc. The results indicate that SSc patients are at an increased risk of AP even after adjusting for common AP risk factors. Further studies are required to validate these findings as it has important clinical implications among SSc patients.

Predictors	Univariate Odds Ratio (95% CI)	P Value	Multivariate Odds Ratio (95% CI)	P Value
Systemic sclerosis	3.54 (3.28 – 3.83)	0.000	2.26 (2.08 - 2.45)	< 0.001
Alcohol abuse	18.66 (18.47 – 18.85)	0.000	9.49 (9.38 - 9.60)	< 0.001
Biliary stone	22.49 (22.32 – 22.66)	0.000	14.06 (13.94 - 14.17)	< 0.001
Triglyceridemia	8.71 (8.59 – 8.83)	0.000	3.66 (3.61 - 3.72)	< 0.001
Hypercalcemia	6.53 (6.42 – 6.65)	0.000	2.67 (2.62 - 2.73)	< 0.001
Obesity	4.36 (4.32 – 4.39)	0.000	2.10 (2.08 - 2.11)	< 0.001
Sex (male)	1.14 (1.13 – 1.14)	0.000	1.12 (1.12 - 1.13)	< 0.001
Smoking	4.28 (4.25 – 4.31)	0.000	2.37 (2.35 – 2.39)	< 0.001

Table: Univariate and Multivariate Logistic Regression Analyses For The Predictors Of Acute Pancreatitis

Disclosures:

Ahmed Eltelbany indicated no relevant financial relationships.

Osama Hamid indicated no relevant financial relationships.

Abdul Mohammed indicated no relevant financial relationships.

George Khoudari indicated no relevant financial relationships.

Prashanthi Thota indicated no relevant financial relationships.

Madhusudan Sanaka indicated no relevant financial relationships.

Ahmed Eltelbany, MD, MPH¹, Osama Hamid, MD¹, Abdul Mohammed, MD², George Khoudari, MD¹, Prashanthi N. Thota, MD¹, Madhusudan Sanaka, MD¹. P1049 - Systemic Sclerosis Patients Have a Higher Risk of Developing Acute Pancreatitis: A Nationwide Population-Based Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.