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- Title
Smoking Is Associated with Worse Clinical Outcomes in Chronic Pancreatitis.
- Authors
Liyen Cartelle, Anabel; Bocchino, Rachel L.; Shah, Ishani; Yakah, William; Ahmed, Awais; Freedman, Steven D.; Kothari, Darshan J.; Sheth, Sunil G.
- Abstract
Background: Tobacco smoking is a known risk factor for progression of chronic pancreatitis (CP). Aim: We compare clinical outcomes of CP patients with current or former smoking with those who have never smoked. Methods: We reviewed all patients with followed at our Pancreas Center from 2016 to 2021, comparing the demographics, clinical features, comorbidities, outcomes, and resource utilization between smokers and non-smokers. Results: Of 439 CP patients, 283 were smokers (125 current, 158 former). Significantly more smokers were men (58.3% vs 40.4%), with alcoholic CP (45.5% vs 12.1%), chronic abdominal pain (77.7% vs 65.4%), anxiety and depression (22.6% vs 14.1% and 38.9% vs 23.1%), and with more local pancreatic complications [splanchnic vein thrombosis (15.7% vs 5.13%), pseudocyst (42.7% vs 23.7%), biliary obstruction (20.5% vs 5.88%)], exocrine pancreatic insufficiency (65.8% vs 46.2%), hospitalizations (2.59 vs 1.75 visits), and emergency department visits (8.96% vs 3.25%). Opioid and neuromodulator use were significantly higher (59.2% vs 30.3% and 58.4% vs 31.2%). Current smokers had worse outcomes than former smokers. Multivariate analysis controlling for multiple factors identified smoking as an independent predictor of chronic abdominal pain (OR 2.49, CI 1.23–5.04, p = 0.011), opioid (OR 2.36, CI 1.35–4.12, p = 0.002), neuromodulators (OR 2.55, CI 1.46–4.46, p = 0.001), and non-opioid-controlled medications (OR 2.28, CI 1.22–4.30, p = 0.01) use, as well as splanchnic vein thromboses (OR 2.65, CI 1.02–6.91, p = 0.045) and biliary obstruction (OR 4.12, CI 1.60–10.61, p = 0.003). Conclusion: CP patients who smoke or formerly smoked have greater morbidity and worse outcomes than non-smokers.
- Subjects
EXOCRINE pancreatic insufficiency; CHRONIC pancreatitis; VENOUS thrombosis; TREATMENT effectiveness; SMOKING; SMOKE
- Publication
Digestive Diseases & Sciences, 2023, Vol 68, Issue 6, p2667
- ISSN
0163-2116
- Publication type
Article
- DOI
10.1007/s10620-023-07841-4