Risk Factors for Steatorrhea in Chronic Pancreatitis: A Cohort of 2,153 Patients

Bai-Rong Li, Jun Pan, Ting-Ting Du, Zhuan Liao, Bo Ye, Wen-Bin Zou, Hui Chen, Jun-Tao Ji, Zhao-Hong Zheng, Dan Wang, Jin-Huan Lin, Shou-Bin Ning, Liang-Hao Hu, Zhao-Shen Li, Bai-Rong Li, Jun Pan, Ting-Ting Du, Zhuan Liao, Bo Ye, Wen-Bin Zou, Hui Chen, Jun-Tao Ji, Zhao-Hong Zheng, Dan Wang, Jin-Huan Lin, Shou-Bin Ning, Liang-Hao Hu, Zhao-Shen Li

Abstract

This study aimed to investigate the occurrence of and determine the risk factors for steatorrhea in chronic pancreatitis (CP). It was based on analysis of both retrospectively and prospectively acquired database for CP patients admitted to our center from January 2000 to December 2013. Demographic data, course of disease, medical history, and follow-up evaluations of patients were documented in detail. Cumulative rate of steatorrhea was calculated by using the Kaplan-Meier method. For risk factor analysis, multivariate analysis by Cox proportional hazards regression model was performed. A total of 2,153 CP patients were included with a mean follow-up duration of 9.3 years. Approximately 14% (291/2,153) of CP patients presented with steatorrhea at diagnosis of CP. Cumulative rates of steatorrhea at 1, 5, 10, and 20 years after diagnosis of CP were 4.27% (95% CI: 3.42%-5.34%), 12.53% (95% CI: 10.74%-14.59%), 20.44% (95% CI: 17.37%-23.98%) and 30.82% (95% CI: 20.20%-45.21%), respectively. Male gender (HR = 1.771, p = 0.004), diabetes (HR = 1.923, p < .001), alcohol abuse (HR = 1.503, p = 0.025) and pancreaticoduodenectomy (HR = 2.901, p < 0.001) were independent risk factors for steatorrhea while CP in adolescents (HR = 0.433, p = 0.009) was a protective factor. In conclusion, male gender, adult, diabetes, alcohol abuse and pancreaticoduodenectomy lead to increased risk of steatorrhea in CP patients.

Figures

Figure 1. Different analyses employed for different…
Figure 1. Different analyses employed for different patients.
Figure 2. Cumulative rates of steatorrhea.
Figure 2. Cumulative rates of steatorrhea.
(a) Overall cumulative rate of steatorrhea after the onset of chronic pancreatitis (CP); (b) Cumulative rates of steatorrhea stratified by gender (male vs. female) after the onset of CP; (c) Overall cumulative rate of steatorrhea after the diagnosis of CP; (d) Cumulative rates of steatorrhea stratified by gender (male vs. female) after the diagnosis of CP; (e) Overall cumulative rate of steatorrhea after successful main pancreatic duct (MPD) drainage; (f) Cumulative rates of steatorrhea stratified by method for MPD drainage (ERCP/ESWL vs. surgery).

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