P2842 - Association Between Body Composition Measured by Artificial Intelligence and the Long-Term Sequelae After Acute Pancreatitis

Pedro Cortes, MD¹, Tyler Mistretta, MD², Brittany Jackson, MD¹, Ahmed Salih, MD³, Caroline Olson, MD¹, Panagiotis Korfiatis, PhD⁴, Jason Klug, PhD⁴, Fernando Stancampiano, MD¹, Dana Harris, MD¹, J Dan Echols, MD¹, Rickey Carter, PhD¹, Baoan Ji, MD, PhD¹, Heather Hardway, PhD¹, Michael Wallace, MD⁵, Vivek Kumbhari, MBBCh, PhD¹, Yan Bi, MD, PhD^1
1Mayo Clinic, Jacksonville, FL; ²Mayo Clinic Florida, Jacksonville, FL; ³Indiana University School of Medicine, Muncie, IN; ⁴Mayo Clinic, Rochester, MN; ⁵Sheikh Shakhbout Medical City, Abu Dhabi, Abu Dhabi, United Arab Emirates

Introduction: About 10-30% of patients with acute pancreatitis (AP) have a recurrent episode. The impact of body composition on recurrent AP is unclear. We aimed to determine the associations between body composition and the long-term sequelae after AP.

Methods: We performed a retrospective study of patients hospitalized for AP in 2018 at three tertiary centers. Patients with CT imaging of the abdomen at admission were included. A fully automated abdominal segmentation algorithm developed by Weston et al.(Radiology 2019) was used for body composition analysis. The primary endpoint was a recurrent hospitalization for AP. Secondary endpoints included a diagnosis of chronic pancreatitis (CP) or diabetes mellitus (DM) in patients evaluated at follow-up. Cox Proportional Hazards regression analysis was used.

Results: 347 patients (median follow-up time: 1035 days, IQR: 697-1515) were included. The most common etiologies were alcohol (28.8%), gallstone (24.2%) and idiopathic (25.1%). 89 patients (25.6%) had a recurrent episode (median time: 219 days, IQR: 74-471). 34 of 112 patients (30.4%) developed CP (median time: 311 days, IQR: 160-797) and 22 of 88 (25.0%) developed DM (median time: 1104 days, IQR: 507-1242). After adjusting for age, male sex, first episode of AP, BUN, and severity of AP; obesity, body mass index (BMI), alcohol pancreatitis, and gallstone pancreatitis were significantly associated with a recurrent episode. Table 1. Body composition was not associated with a recurrent episode. In unadjusted analysis, BMI (HR 0.66, p=0.0052), obesity (HR 0.36, p=0.0131), history of DM (HR 2.12, p=0.0371), and subcutaneous adipose tissue (SAT) (HR 0.87 per 10 cm², p=0.002) were associated with a diagnosis of CP. Skeletal muscle (SM) mass approached significance for CP (HR 1.33 per 10 cm², p=0.0546). Mean corpuscular volume (HR 0.45 per 10 fL, p=0.0209) and intermuscular adipose tissue (IMAT) (HR 1.45 per 5 cm², p=0.0264) were associated with DM at follow-up.

Discussion: In this multi-site retrospective study, we found body mass composition was not associated with a recurrent episode of AP after adjusting for age, male sex, having an initial episode, and AP severity. At follow-up, 30% and 25% of patients developed CP and DM at approximately one and three years, respectively. In unadjusted analysis, a higher SAT and IMAT were associated with a lower incidence of CP and a higher incidence of DM, respectively. Further studies are needed to corroborate these findings and to examine other long-term sequelae.



Disclosures:


Pedro Cortes, MD¹, Tyler Mistretta, MD², Brittany Jackson, MD¹, Ahmed Salih, MD³, Caroline Olson, MD¹, Panagiotis Korfiatis, PhD⁴, Jason Klug, PhD⁴, Fernando Stancampiano, MD¹, Dana Harris, MD¹, J Dan Echols, MD¹, Rickey Carter, PhD¹, Baoan Ji, MD, PhD¹, Heather Hardway, PhD¹, Michael Wallace, MD⁵, Vivek Kumbhari, MBBCh, PhD¹, Yan Bi, MD, PhD¹. P2842 - Association Between Body Composition Measured by Artificial Intelligence and the Long-Term Sequelae After Acute Pancreatitis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.