Association between Obesity and Mortality in Patients with Acute Pancreatitis

Obesity is increasingly recognized as an important modifier of disease severity and outcomes in acute pancreatitis. Excess adiposity may worsen the inflammatory response, leading to a more severe clinical course and higher mortality. Limited local data are available regarding this association in the Pakistani population. This study assessed the impact of obesity on disease severity, complications, and mortality in patients with acute pancreatitis. Methods: An observational analytical study was conducted among 80 patients diagnosed with acute pancreatitis at Shaikh Zayed Hospital, Lahore, from June to December 2024. Demographic variables, body mass index (BMI), etiology, severity based on the Revised Atlanta Classification, and clinical outcomes were recorded. Patients were categorized as obese or non-obese using WHO South Asian BMI cutoffs. Outcomes compared between the two groups included severity, ICU admission, organ failure, length of stay, and mortality. Logistic regression identified independent predictors of mortality. Data were analyzed using SPSS 26. Results: The mean age of patients was 47.6 ± 13.2 years, with 52.5 percent males. Obesity was present in 35.0 percent of the cohort. Gallstones were the most common etiology (45 percent). Severe pancreatitis occurred more frequently in obese patients compared with non-obese patients (35.7 percent vs 15.4 percent). Obese patients also had significantly higher rates of ICU admission (42.8 percent vs 19.2 percent), organ failure (32.1 percent vs 11.5 percent), longer hospital stay (9.1 ± 3.4 vs 6.8 ± 2.9 days), and higher mortality (25 percent vs 5.8 percent). In multivariable analysis, obesity (adjusted OR 3.84), severe pancreatitis (adjusted OR 5.76), and organ failure (adjusted OR 4.19) emerged as independent predictors of mortality. Conclusion: Obesity was strongly associated with increased severity, complications, prolonged hospitalization, and higher mortality in patients with acute pancreatitis. These findings highlight the need for early risk stratification and tailored management strategies for obese individuals presenting with acute pancreatitis.