Coexistent alcohol-related cirrhosis and chronic pancreatitis have a comparable phenotype to either disease alone: A comparative retrospective analysis

Table 1 Select demographics and characteristics in the study population, n (%)

	CD (n = 133)	ALC only (n = 135)	ACP only (n = 87)	P value (CD vs ALC only)	P valve (CD vs ACP only)
Age (at study entry), yr – mean ± SD	51.7 ± 12.0	54.6 ± 9.8	51.0 ± 12.3	0.029	0.684
Female	49 (38)	42 (31)	20 (23)	0.322	0.03
Race				0.015	0.52
Caucasian	97 (73)	113 (84)	61 (70)
Black	30 (23)	22 (16)	24 (28)
Other	6 (5)	0 (0)	2 (2)
Body mass indexa – mean ± SD	24.2 ± 7.0	27.8 ± 6.5	23.3 ± 5.4	< 0.001	0.281
Tobacco use	117 (88)	109 (81)	81 (93)	0.104	0.127
Smoking (one or more packs per day	31 (23)	23 (17)	24 (28)	0.29	0.392
Alcohol use (duration), yr – mean ± SD	26.7 ± 16.0	29.4 ± 13.8	23 ± 18.4	0.595	0.762
Hepatitis B Infection	7 (5)	17 (13)	2 (2)	0.036	0.278
Hepatitis C Infection	31 (23)	58 (43)	14 (16)	0.001	0.194
Non-Elective Hospital Admissionsb – median (IQR)	4 (1 - 12)	3 (0 - 7)	4 (1 - 8)	0.007	0.57
Duration of observation, yr – mean ± SD	10.8 ± 7.9	12.4 ± 7.6	11.8 ± 7.6	0.107	0.36

^aAt most recent contact.

^bCompared using Kruskal-Wallis test. ACP: Alcohol-related chronic pancreatitis; ALC: alcohol-related liver cirrhosis; CD: Coexistent disease; IQR: Interquartile range.

Table 2 Select disease-specific characteristics in patients with coexistent disease vs alcohol-related liver cirrhosis only, n (%)

Characteristics present	CD (n = 133)	ALC only (n = 135)	P value
Verification criteria fulfilled
Liver biopsy performed	22 (17)	45 (33)	0.002
Cirrhosis on biopsy	13 (59)	22 (49)	0.349
Cirrhosis on imagingb	101 (76)	126 (93)	< 0.001
Portal hypertension features on imaging	78 (59)	100 (74)	0.006
Alcohol-Related hepatitis	48 (36)	34 (25)	0.052
MELD scorea	19.3 ± 8.98	18.7 ± 8.89	0.614
Child-Pugh scorea			0.69
A	41 (31)	48 (36)
B	49 (39)	48 (36)
C	43 (32)	39 (29)
Complications of portal hypertension
Esophageal varices on EGD	46 (35)	68 (50)	< 0.001
Esophageal variceal hemorrhage	11 (8)	17 (13)	0.247
Ascites	96 (72)	83 (62)	0.063
Spontaneous bacterial peritonitis	22 (17)	9 (7)	0.011
Portosystemic encephalopathy	62 (47)	68 (50)	0.539
Hepatocellular carcinoma	6 (5)	23 (17)	0.001
End-stage renal disease requiring CRRT/HD	15 (11)	13 (10)	0.644
Treatment of portal hypertension/complications
Esophageal variceal banding	11 (8)	22 (16)	0.046
TIPS	3 (2)	8 (6)	0.13
Beta-blocker usea	18 (14)	38 (28)	0.004
Diuretic usea	57 (43)	65 (48)	0.415
Large volume paracentesis	29 (22)	39 (29)	0.183
Antibiotics for SBP prophylaxisa	9 (7)	11 (8)	0.68
Lactulose and/or rifaximin usea	50 (38)	55 (41)	0.632
Transplant evaluation	14 (11)	19 (14)	0.402
Liver transplantation	3 (2)	10 (7)	0.05

^aAt most recent contact.

^bUltrasound, computed tomography scan magnetic resonance imaging, elastography. ALC: Alcohol-related liver cirrhosis; CD: Coexistent disease; CRRT: Continuous renal replacement therapy; HD: Homeodomain; EGD: Esophagogastroduodenoscopy; SBP: Spontaneous bacterial peritonitis.

Table 3 Select disease-specific characteristics in patients with coexistent disease vs alcohol-related chronic pancreatitis only, n (%)

Characteristics present	CD (n = 133)	Only ACP (n = 87)	P value
Verification criteria fulfilled on imaging
Pancreatic calcifications	88 (66)	64 (74)	0.246
Moderate-severe ductal dilatation	38 (29)	30 (35)	0.354
Moderate-severe ductal structure	18 (14)	14 (16)	0.599
Any gland atrophy	77 (58)	46 (53)	0.463
Moderate-severe gland atrophy	10 (13)	7 (15)	0.88
Gland atrophy not reported	67 (87)	37 (80)	0.25
Diagnosis based on EUS alone	6 (5)	5 (6)	0.681
Chronic pancreatitis features
Acute pancreatitis	101 (76)	74 (85)	0.009
Age at first pancreatitis, yr – mean ± SD	48.1 ± 15.2	41.5 ± 10.6	0.112
Recurrent acute pancreatitis	61 (46)	53 (61)	0.023
Chronic abdominal paina	56 (42)	44 (51)	0.189
Pancreatic pseudocyst	29 (22)	22 (25)	0.549
Diabetes mellitus	54 (41)	50 (58)	0.011
Exocrine pancreatic insufficiency (Fecal elastase < 100 and/or steatorrhea)	24 (18)	14 (16)	0.708
Pancreatic adenocarcinoma	2 (2)	4 (5)	0.163
Treatment of chronic pancreatitis/complications
Oral anti-diabetic therapya	11 (20)	13 (26)	0.113
Insulin therapya	46 (85)	37 (74)	0.209
Pancreatic enzymatic replacement therapya	35 (26)	39 (45)	0.004
Chronic opiate therapya	59 (44)	33 (38)	0.381
Treatment by chronic pain specialist	20 (15)	20 (23)	0.124
Celiac plexus block	0 (0)	2 (2)	0.077
ERCP	41 (31)	43 (49)	0.004
Pseudocyst drainage (endoscopic/surgical)	18 (14)	13 (15)	0.743
Pancreatic surgery	13 (10)	19 (22)	0.012
Pertinent test results
Hemoglobin A1Ca – mean ± SD	6.4 ± 2.3	7.3 ± 2.1	0.01
Vitamin D deficiency	48 (36)	25 (29)	0.104
DEXA scan performed	28 (21)	19 (22)	0.855
Osteopenia on DEXA scan	12 (43)	10 (53)	0.51
Osteopenia on DEXA scan	8 (29)	5 (26)	0.865

^aAt most recent contact. ACP: Alcohol-related chronic pancreatitis; CD: Coexistent disease; ERCP: Endoscopic retrograde cholangiopancreatography; DEXA: Dual-energy-xray-absorptiometry.