PP400 - NUTRITIONAL STATUS AT ADMISSION AND CLINICAL OUTCOMES IN ACUTE PANCREATITIS: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

PP400

NUTRITIONAL STATUS AT ADMISSION AND CLINICAL OUTCOMES IN ACUTE PANCREATITIS: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

O. J. Zahariev^1,2,*, L. Havelda^2,3, K. L. Vámossy¹, G. Soós^1,2, B. C. Budai^2,3, R. J. Reszkető¹, D. Tarján^1,2, M. Lipp^1,2, E. R. Fürst^1,2, S. Váncsa^1,2, Z. I. Bánfalvi^1,2, B. Barna^1,2, I. Rajci¹, P. J. Hegyi^1,2, B. M. Erőss^1,2,4, P. Sahin¹, P. Hegyi^1,2,4,5

¹Institute of Pancreatic Diseases, ²Centre for Translational Medicine, ³Department of Dietetics and Nutritional Sciences, Semmelweis University, Budapest, ⁴Institute for Translational Medicine, Medical School, University of Pécs, Pécs, ⁵Translational Pancreatology Research Group, Interdisciplinary Center of Excellence for Research Development and Innovation, University of Szeged, Szeged, Hungary

Rationale: Poor nutritional status is associated with adverse outcomes in many diseases, but data in acute pancreatitis (AP) are limited. We aimed to explore the relationship between nutritional status at admission and in-hospital outcomes in AP.

Methods: This prospective cohort study included consecutively hospitalised AP cases between 2021.10.04 and 2024.09.30. On admission body mass index (BMI), malnutrition risk (Malnutrition Universal Screening Tool, MUST) and malnutrition diagnosis (Global Leadership Initiative on Malnutrition, GLIM) were recorded. Associations with AP severity, mortality, and length of hospital stay (LOH) were analyzed.

Results: Among 1,807 admissions, 3.0% were underweight, 28.4% normal weight, 32.7% overweight and 35.9% obese. Malnutrition risk was elevated in 25.8% and 16.2% were malnourished. The proportion of severe AP rose with BMI, while malnutrition was evenly distributed across severity categories. Patients with MUST ≥3 had severe AP more often than those at lower risk (41.0% vs 29.5%). LOH ≥7 days was least frequent in normal-weight patients (25.8%), higher in overweight (31.7%) and obese (34.4%), and highest in underweight patients (38.0%) (p<0.001). MUST ≥4 was associated with a mean LOH increase of 5.2 days (p<0.001), and 36.4% of severely malnourished patients stayed ≥7 days. Mortality doubled in underweight versus higher-BMI groups (4.0% vs 1.7%) and increased in MUST ≥3 (4.8% vs 1.5%) and malnourished (3.0% vs 1.5%) cases.

Conclusion: Pre-existing undernutrition is associated with prolonged hospitalisation and increased mortality but not AP severity. Conversely, obesity is linked to severe AP and longer LOH, but not mortality. Both undernutrition and obesity are linked to poorer prognosis in AP.

Disclosure of Interest: None declared