SUN-557 Hypertriglyceridemia-Induced Pancreatitis: Experience from a Quaternary Care Center
Bibliographic record
Abstract
Abstract Severe hypertriglyceridemia is defined by triglycerides levels reaching 11,3 mmol/L (1000 mg/dL) or when chylomicrons are present in the circulation (1). Severe hypertriglyceridemia increases the risk of acute pancreatitis, a serious complication that can be recurrent and fatal. Severe hypertriglyceridemia is most often caused by an underlying primary chylomicronemia disease, either monogenic of multifactorial. Familial chylomicronemia syndrome is a rare autosomal recessive disease that can result from mutations in lipoprotein lipase in more than 90% of cases. Multifactorial chylomicronemia is an oligogenic or polygenic disorder characterized by a reduction in lipoprotein lipase activity. Primary chylomicronemia should be managed in a specialized lipid clinic before acute pancreatitis occur. However, primary chylomicronemia is underdiagnosed (2). This is why hospitalization for an acute episode of hypertriglyceridemia-induced pancreatitis is a window of opportunity to investigate these patients. The first objective of our study was to investigate retrospectively the quality of the follow-up of patients hospitalized for hypertriglyceridemia-induced acute pancreatitis, specifically looking at specialized lipid clinic referrals. The second objective was to correlate triglyceride (TG) levels with severity of the pancreatitis. A total of 1063 patients were hospitalized for acute pancreatitis at our center between 2012 and 2019. Twenty-five patients (2.35%) were diagnosed with hypertriglyceridemia-induced pancreatitis. Of those 25 patients, one died of pancreatitis complications, two were already diagnosed with primary chylomicronemia, and of the remaining twenty-two, 11 (50%) had a referral for an evaluation at a specialized lipid clinic. Those referrals resulted in three diagnoses of primary chylomicronemia, with a multidisciplinary follow-up. Regarding severity of pancreatitis, TG levels were positively correlated with patients being hospitalized in the intensive care unit (ICU) and also having longer stays in the ICU. Only half of patients hospitalized for a hypertriglyceridemia-induced pancreatitis at our center had a referral for lipid disorder evaluation upon hospital discharge. We believe it is important to raise awareness concerning primary chylomicronemia to avoid recurrent acute pancreatitis preceding diagnosis, seeing this pathology increases morbidity and mortality. 1. Valdivielso et al. Eur J Intern Med. 2014;25(8):689-94. 2. Brown et al. J Clin Lipidol. 2018;12(2):254-263.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".