Background: Research into clinical determinants of severe acute pancreatitis remains important for therapeutic and preventive purposes. To contribute to prognostication, this study aimed to define clinical risk factors for the development of severe acute pancreatitis.

Methods: Study design was a prospective cohort study, using multiple logistic regression. From March 2004 to July 2007, 153 cases of acute pancreatitis were recruited in a regional Australian hospital. Data were collected regarding demographic and clinical characteristics. The outcome measure was severe acute pancreatitis, as defined by composite consensus criteria.

Results: After adjustment for potential confounders, there was a significant positive association with waist circumference and a negative association with current smoking status.

Conclusion: The study confirms other work suggesting central adiposity as a risk factor for severe acute pancreatitis. The finding of a possible protective effect for smoking may be physiologically plausible but merits further confirmatory research.