Chronic Pancreatitis Is Characterized by Distinct Complication Clusters That Associate With Etiological Risk Factors

Søren S Olesen, Camilla Nøjgaard, Jakob L Poulsen, Stephan L Haas, Miroslav Vujasinovic, Matthias Löhr, Björn Lindkvist, Louise Bexander, Antanas Gulbinas, Evangelos Kalaitzakis, Mohamed Ebrahim, Friedemann Erchinger, Trond Engjom, Stine Roug, Srdan Novovic, Truls Hauge, Anne Waage, Johanna Laukkarinen, Mikael Parhiala, Aldis Pukitis & 3 andre Imanta Ozola-Zālīte, Asbjørn M Drewes, Scandinavian Baltic Pancreatic Club

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

OBJECTIVES: Chronic pancreatitis (CP) is characterized by several disease-related complications and multiple etiological risk factors. Past studies of associations between complications and risk factors have mostly been limited to single complications or highly focused on single etiologies. Using an objective data-driven approach (cluster analysis), we characterized complication clusters and their associations with etiological risk factors in a large cohort of patients with CP.

METHODS: This was a multicenter, cross-sectional study including 1,071 patients with CP from the Scandinavian and Baltic countries. Complications to CP were classified according to the M-ANNHEIM system, and treelet transform was used to derive complication clusters. Cluster complication frequencies were analyzed for their association with main etiological risk factors (smoking and alcohol).

RESULTS: The mean age of participants was 57 years and 66% were men. Alcohol (55%) and smoking (53%) were the most common etiological risk factors and seen in combination in 36% of patients. Cluster analysis identified 3 distinct complication clusters characterized by inflammation, fibrosis, and pancreatic insufficiencies. An independent association between inflammatory complications and alcoholic etiology was seen (odds ratio [OR] 2.00 [95% CI [confidence interval], 1.38-2.90], P < 0.001), whereas smoking was associated with fibrosis-related complications (OR 2.23 [95% CI, 1.56-2.3.20], P < 0.001) and pancreatic insufficiencies (OR 1.42 [95% CI, 1.00-2.01], P = 0.046).

DISCUSSION: Three distinctive clusters of complications to CP were identified. Their differing associations with alcoholic and smoking etiology indicate distinct underlying disease mechanisms.

OriginalsprogEngelsk
TidsskriftThe American Journal of Gastroenterology
Vol/bind114
Udgave nummer4
Sider (fra-til)656-664
ISSN0002-9270
DOI
StatusUdgivet - 2019

Fingeraftryk

Chronic Pancreatitis
Smoking
Exocrine Pancreatic Insufficiency
Odds Ratio
Confidence Intervals
Cluster Analysis
Fibrosis
Alcohols
Cross-Sectional Studies
Inflammation

Citer dette

Olesen, Søren S ; Nøjgaard, Camilla ; Poulsen, Jakob L ; Haas, Stephan L ; Vujasinovic, Miroslav ; Löhr, Matthias ; Lindkvist, Björn ; Bexander, Louise ; Gulbinas, Antanas ; Kalaitzakis, Evangelos ; Ebrahim, Mohamed ; Erchinger, Friedemann ; Engjom, Trond ; Roug, Stine ; Novovic, Srdan ; Hauge, Truls ; Waage, Anne ; Laukkarinen, Johanna ; Parhiala, Mikael ; Pukitis, Aldis ; Ozola-Zālīte, Imanta ; Drewes, Asbjørn M ; Scandinavian Baltic Pancreatic Club. / Chronic Pancreatitis Is Characterized by Distinct Complication Clusters That Associate With Etiological Risk Factors. I: The American Journal of Gastroenterology. 2019 ; Bind 114, Nr. 4. s. 656-664.
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title = "Chronic Pancreatitis Is Characterized by Distinct Complication Clusters That Associate With Etiological Risk Factors",
abstract = "OBJECTIVES: Chronic pancreatitis (CP) is characterized by several disease-related complications and multiple etiological risk factors. Past studies of associations between complications and risk factors have mostly been limited to single complications or highly focused on single etiologies. Using an objective data-driven approach (cluster analysis), we characterized complication clusters and their associations with etiological risk factors in a large cohort of patients with CP.METHODS: This was a multicenter, cross-sectional study including 1,071 patients with CP from the Scandinavian and Baltic countries. Complications to CP were classified according to the M-ANNHEIM system, and treelet transform was used to derive complication clusters. Cluster complication frequencies were analyzed for their association with main etiological risk factors (smoking and alcohol).RESULTS: The mean age of participants was 57 years and 66{\%} were men. Alcohol (55{\%}) and smoking (53{\%}) were the most common etiological risk factors and seen in combination in 36{\%} of patients. Cluster analysis identified 3 distinct complication clusters characterized by inflammation, fibrosis, and pancreatic insufficiencies. An independent association between inflammatory complications and alcoholic etiology was seen (odds ratio [OR] 2.00 [95{\%} CI [confidence interval], 1.38-2.90], P < 0.001), whereas smoking was associated with fibrosis-related complications (OR 2.23 [95{\%} CI, 1.56-2.3.20], P < 0.001) and pancreatic insufficiencies (OR 1.42 [95{\%} CI, 1.00-2.01], P = 0.046).DISCUSSION: Three distinctive clusters of complications to CP were identified. Their differing associations with alcoholic and smoking etiology indicate distinct underlying disease mechanisms.",
author = "Olesen, {S{\o}ren S} and Camilla N{\o}jgaard and Poulsen, {Jakob L} and Haas, {Stephan L} and Miroslav Vujasinovic and Matthias L{\"o}hr and Bj{\"o}rn Lindkvist and Louise Bexander and Antanas Gulbinas and Evangelos Kalaitzakis and Mohamed Ebrahim and Friedemann Erchinger and Trond Engjom and Stine Roug and Srdan Novovic and Truls Hauge and Anne Waage and Johanna Laukkarinen and Mikael Parhiala and Aldis Pukitis and Imanta Ozola-Zālīte and Drewes, {Asbj{\o}rn M} and {Scandinavian Baltic Pancreatic Club}",
year = "2019",
doi = "10.14309/ajg.0000000000000147",
language = "English",
volume = "114",
pages = "656--664",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
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Olesen, SS, Nøjgaard, C, Poulsen, JL, Haas, SL, Vujasinovic, M, Löhr, M, Lindkvist, B, Bexander, L, Gulbinas, A, Kalaitzakis, E, Ebrahim, M, Erchinger, F, Engjom, T, Roug, S, Novovic, S, Hauge, T, Waage, A, Laukkarinen, J, Parhiala, M, Pukitis, A, Ozola-Zālīte, I, Drewes, AM & Scandinavian Baltic Pancreatic Club 2019, 'Chronic Pancreatitis Is Characterized by Distinct Complication Clusters That Associate With Etiological Risk Factors' The American Journal of Gastroenterology, bind 114, nr. 4, s. 656-664. https://doi.org/10.14309/ajg.0000000000000147

Chronic Pancreatitis Is Characterized by Distinct Complication Clusters That Associate With Etiological Risk Factors. / Olesen, Søren S; Nøjgaard, Camilla; Poulsen, Jakob L; Haas, Stephan L; Vujasinovic, Miroslav; Löhr, Matthias; Lindkvist, Björn; Bexander, Louise; Gulbinas, Antanas; Kalaitzakis, Evangelos; Ebrahim, Mohamed; Erchinger, Friedemann; Engjom, Trond; Roug, Stine; Novovic, Srdan; Hauge, Truls; Waage, Anne; Laukkarinen, Johanna; Parhiala, Mikael; Pukitis, Aldis; Ozola-Zālīte, Imanta; Drewes, Asbjørn M; Scandinavian Baltic Pancreatic Club.

I: The American Journal of Gastroenterology, Bind 114, Nr. 4, 2019, s. 656-664.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Chronic Pancreatitis Is Characterized by Distinct Complication Clusters That Associate With Etiological Risk Factors

AU - Olesen, Søren S

AU - Nøjgaard, Camilla

AU - Poulsen, Jakob L

AU - Haas, Stephan L

AU - Vujasinovic, Miroslav

AU - Löhr, Matthias

AU - Lindkvist, Björn

AU - Bexander, Louise

AU - Gulbinas, Antanas

AU - Kalaitzakis, Evangelos

AU - Ebrahim, Mohamed

AU - Erchinger, Friedemann

AU - Engjom, Trond

AU - Roug, Stine

AU - Novovic, Srdan

AU - Hauge, Truls

AU - Waage, Anne

AU - Laukkarinen, Johanna

AU - Parhiala, Mikael

AU - Pukitis, Aldis

AU - Ozola-Zālīte, Imanta

AU - Drewes, Asbjørn M

AU - Scandinavian Baltic Pancreatic Club

PY - 2019

Y1 - 2019

N2 - OBJECTIVES: Chronic pancreatitis (CP) is characterized by several disease-related complications and multiple etiological risk factors. Past studies of associations between complications and risk factors have mostly been limited to single complications or highly focused on single etiologies. Using an objective data-driven approach (cluster analysis), we characterized complication clusters and their associations with etiological risk factors in a large cohort of patients with CP.METHODS: This was a multicenter, cross-sectional study including 1,071 patients with CP from the Scandinavian and Baltic countries. Complications to CP were classified according to the M-ANNHEIM system, and treelet transform was used to derive complication clusters. Cluster complication frequencies were analyzed for their association with main etiological risk factors (smoking and alcohol).RESULTS: The mean age of participants was 57 years and 66% were men. Alcohol (55%) and smoking (53%) were the most common etiological risk factors and seen in combination in 36% of patients. Cluster analysis identified 3 distinct complication clusters characterized by inflammation, fibrosis, and pancreatic insufficiencies. An independent association between inflammatory complications and alcoholic etiology was seen (odds ratio [OR] 2.00 [95% CI [confidence interval], 1.38-2.90], P < 0.001), whereas smoking was associated with fibrosis-related complications (OR 2.23 [95% CI, 1.56-2.3.20], P < 0.001) and pancreatic insufficiencies (OR 1.42 [95% CI, 1.00-2.01], P = 0.046).DISCUSSION: Three distinctive clusters of complications to CP were identified. Their differing associations with alcoholic and smoking etiology indicate distinct underlying disease mechanisms.

AB - OBJECTIVES: Chronic pancreatitis (CP) is characterized by several disease-related complications and multiple etiological risk factors. Past studies of associations between complications and risk factors have mostly been limited to single complications or highly focused on single etiologies. Using an objective data-driven approach (cluster analysis), we characterized complication clusters and their associations with etiological risk factors in a large cohort of patients with CP.METHODS: This was a multicenter, cross-sectional study including 1,071 patients with CP from the Scandinavian and Baltic countries. Complications to CP were classified according to the M-ANNHEIM system, and treelet transform was used to derive complication clusters. Cluster complication frequencies were analyzed for their association with main etiological risk factors (smoking and alcohol).RESULTS: The mean age of participants was 57 years and 66% were men. Alcohol (55%) and smoking (53%) were the most common etiological risk factors and seen in combination in 36% of patients. Cluster analysis identified 3 distinct complication clusters characterized by inflammation, fibrosis, and pancreatic insufficiencies. An independent association between inflammatory complications and alcoholic etiology was seen (odds ratio [OR] 2.00 [95% CI [confidence interval], 1.38-2.90], P < 0.001), whereas smoking was associated with fibrosis-related complications (OR 2.23 [95% CI, 1.56-2.3.20], P < 0.001) and pancreatic insufficiencies (OR 1.42 [95% CI, 1.00-2.01], P = 0.046).DISCUSSION: Three distinctive clusters of complications to CP were identified. Their differing associations with alcoholic and smoking etiology indicate distinct underlying disease mechanisms.

U2 - 10.14309/ajg.0000000000000147

DO - 10.14309/ajg.0000000000000147

M3 - Journal article

VL - 114

SP - 656

EP - 664

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 4

ER -