Pancreatitis Necrotizing

Full details of phenotyping are described in the Supplementary Note. Briefly, clinical endpoints with corresponding dates were constructed for gestational diabetes and related diagnoses for exclusions for all FinnGen participants as described in the Supplementary Note. Temporal phenotyping was then performed to phenotype each pregnancy for presence of glycemic disease and then assign individuals as cases or controls. Beginning with 330,000 pregnancies among genotyped FinnGen participants, we defined a “pregnancy window” of 40 before delivery until 5 weeks after delivery. A pregnancy met inclusion criteria for “gestational diabetes” if it had (I1) gestational diabetes ICD codes occurring in the pregnancy window, (I2) any diabetes codes occurring in the pregnancy window (e.g. for ICD8), or (I3) abnormal blood glucose test results in the Medical birth register, which contains data on the mother’s diseases during pregnancy. Pregnancies were then excluded for: (E1) any previous diabetes diagnosis code occurring outside a pregnancy window; (E2) any previous significant pancreatic disease, including chronic pancreatitis, pancreatic necrosis, pancreatic cancer, or cystic fibrosis; or (E3) any previous Type 1 or Type 2 diabetes code. Pregnancies passing these exclusion criteria and without any inclusion criteria for gestational diabetes were designated as “unaffected”. Then to phenotype individuals, cases were identified among the 151,000 genotyped females with a history of pregnancy as those at least 1 pregnancy meeting inclusion criteria for gestational diabetes and passing exclusion criteria. Controls were defined as females with only “unaffected” pregnancies (i.e. no diabetes or significant pancreatic diseases occurring prior to or during any pregnancy, and no abnormal blood glucose in the Medical birth register).

The study database contains the predicted outcome’s value and a series of variables selected as predictors for each patient.
The outcome to be predicted by our model is the presence or absence of postoperative complications in the first month after surgical intervention. Short-term postoperative complications were defined to be: sepsis; variceal hemorrhage; renal dysfunction; respiratory failure; disseminated intravascular coagulation; septic shock; multiple organ dysfunction syndromes; cardiac arrest; multiple systems organ failures; post-transplant lymphoproliferative disorder; biliary anastomosis stenosis—endoscopic stent; tumor recurrence, peritoneal carcinomatosis; HCV reinfection; graft infection with the hepatitis B virus; idiopathic transverse colon necrosis; bone and brain metastases; necrotizing pancreatitis; hepatic artery thrombosis; hemoperitoneum; primary non-functioning of the transplant graft; or common bile duct necrosis.
The following 14 clinical and laboratory pre-transplant parameters were collected and used as predictors: age, sex, blood type (ABO, RH), the diagnosis which prompted the need for liver transplantation (1—hepatitis C cirrhosis; 2—hepatitis C cirrhosis and HCC; 3—coinfection of HCV, hepatitis B virus and hepatitis D virus; 4—HCC associated with the coinfection of HCV, hepatitis B virus and hepatitis D virus), age at diagnosis, MELD-Na score, alpha-fetoprotein, pre-transplant antiviral treatment, liver re-transplantation, total bilirubin, platelet count, albumin, international normalized ratio, and the presence of ascites.

The evaluation of AP with computed tomography was performed. All procedures have a portal venous phase 35 s after administering intravenous contrast. CT was performed at least 24 h after the onset of abdominal pain and preferably between 72 and 96 h. The indications for performing CT in our hospital were: suspicion of moderate/severe or severe AP, presence of persistent SIRS, differential diagnosis with other causes of acute abdomen, and etiological study of non-biliary AP.
Pancreatic necrosis was defined as the absence of enhancement in pancreatic tissue after contrast-enhanced CT. Infected pancreatic necrosis (IPN) was defined as a positive culture for microorganisms after necrosectomy or interventional drainage (radiological or endoscopic) [32 (link)].