Acute pancreatitis due to hypertriglyceridemia: Plasmapheresis versus medical treatment
Gonca Koksaldi Sahin1
, Muge Gulen1, Selen Acehan1, Nurdan Unlu2, Yilmaz Celik3, Deniz Aka Satar4, Mustafa Sencer Segmen1, Salim Satar1
1Emergency Medicine Clinic, Adana City Training and Research Hospital, Health Sciences University, Adana, Turkey
2Anesthesiology and Reanimation Clinic, Intensive Care Unit, Adana City Training and Research Hospital, Adana, Turkey
3Gastroenterology Clinic, Adana City Training and Research Hospital, Health Sciences University, Adana, Turkey
4Department of Histology and Embryology, Assisted Reproduction Unit, Andrology Laboratory, Adana City Training and Research Hospital, Health Sciences University, Adana, Turkey
Keywords: Bedside index of severity in acute pancreatitis, hypertriglyceridemia, lipemic index, pancreatitis, plasmapheresis
Abstract
OBJECTIVE: Hypertriglyceridemia (HTG) is the third most common cause of acute pancreatitis. Plasmapheresis is an extracorporeal treatment method used for treatment. This study aimed to investigate the efficacy of medical treatment and plasmapheresis in patients with acute pancreatitis due to HTG.
METHODS: This was a retrospective cross sectional study. The patients were divided into two groups according to the treatment they received as those who received only medical treatment and those who performed plasmapheresis with medical treatment. According to the treatment received by the patients; clinical, demographic, and laboratory data, Ranson scores, and bedside index of severity in acute pancreatitis (BISAP) scores, decrease in triglyceride levels in 24 h, length of hospital stay, and outcomes were recorded.
RESULTS: Forty seven patients were included in the study. The level of triglyceride decreases at the 24th h was 59.7% ±17.3% in those who received medical treatment and was 70.4% ±15.1% in those who received plasmapheresis (P = 0.032). Receiver operating characteristic curve analysis was performed to predict the need for plasmapheresis treatment, area under the curve (AUC) value of the triglyceride level was the highest (AUC: 0.822, 95% confidence interval: [0.703–0.940]; P < 0.001), the sensitivity and specificity were 83.3% and 72.4%, respectively, and the cut off value of triglyceride was accepted as 3079.5 mg/dL.
CONCLUSION: Plasma triglyceride levels and BISAP score on admission may help physicians to predict the need for plasmapheresis. Plasmapheresis helps to rapidly reduce triglyceride levels in patients with HTG associated acute pancreatitis.
How to cite this article: Sahin GK, Gulen M, Acehan S, Unlu N, Celik Y, Satar DA, et al. Acute pancreatitis due to hypertriglyceridemia: Plasmapheresis versus medical treatment. Turk J Emerg Med. Turk J Emerg Med 2023;23:111-8.
The Ethical Committee of Cukurova University approved the study and confirmed that the protocol was compatible with the second Declaration of Helsinki(Approval date: May 21, 2021, Decision number: 67 Meet number: 111).
GKS, MG, SS, and SA were the coordination researcher of the study and were concerned with study design, implementation, study monitoring, data collection, and interpretation. GKS, SS, MG, SA, and NKU were involved in the study design, study monitoring and supervision, and interpretation of data. MG, SA, NKU, YC, and MSS were researchers and were involved in data collection and interpretation. GKS, SS, MG, SA, NKU, YC, and MSS were involved in study design, statistical analysis, and data interpretation. All authors reviewed the drafts and approved the final version of the article for submission.
None Declared.
None.