Abstract
BACKGROUND AND AIM: Obesity is a well-known risk factor for the development and severity of acute pancreatitis (AP), but the relationship between the abdominal visceral fat area (VFA) and mortality is unclear. We evaluated the effect of the VFA on mortality in severe AP (SAP). METHODS: This retrospective, single-center cohort study examined 119 consecutive patients with SAP from April 2009 to March 2019. The VFA at the umbilical level was assessed using computed tomography. The primary endpoint was to evaluate whether visceral obesity affects mortality in SAP. RESULTS: The median age was 63 years, and 66% of participants were male. Nine patients (7.5%) died during their hospital stay. The median body mass index (BMI) was 22.2 kg/m(2), and six obese patients had a BMI of over 30 kg/m(2) (5%). The median waist circumference and VFA were 85.5 cm and 112 cm(2), respectively. Sixty-eight (57.1%) patients had a VFA over 100 cm(2). The prognostic factor score based on the Japanese guidelines for AP management (cutoff value [COV], 4; area under the curve [AUC] = 0.869) and age [COV, 72; AUC = 0.780]) showed moderate accuracy for predicting mortality, followed by the VFA (COV, 167 cm(2); AUC = 0.679). Univariate logistic analysis, but not multivariate analysis, showed that an increased VFA was associated with a significantly higher odds ratio (OR) for predicting mortality (OR: 4.38, P = 0.0406). The survival times of SAP patients with and without an increased VFA of 167 cm(2) were not significantly different. CONCLUSIONS: Visceral obesity did not have a significant impact on predicting mortality in patients with SAP.