A population-based study of severity in patients with acute on chronic pancreatitis.

Abstract:

OBJECTIVES:The objectives of this study were to evaluate the severity of patients with acute pancreatitis (AP) on chronic pancreatitis (CP) and compare this to patients with AP without CP. METHODS:The Maryland Health Services database was queried for all adult inpatient discharges with a primary diagnosis of AP from 1994 to 2010. Acute pancreatitis on CP and AP without CP were defined by the presence of the associated diagnosis code for CP. Severity was defined as organ failure, intensive care unit stay, or mortality. RESULTS:Acute pancreatitis on CP accounted for 13.7% of all AP discharges (9747/70,944). The proportion of AP-on-CP discharges doubled during the study period (8.8% to 17.6%; P < 0.0001). When compared with patients with AP without CP, AP-on-CP patients were younger, were more likely to be male and black, had higher rates of alcohol and drug abuse, and had less severe disease with lower rates of mortality, organ failure, need for mechanical ventilation, and intensive care unit stay. Among AP-on-CP patients, significant predictors of severity included advanced age, weight loss, and 2 or more comorbidities. CONCLUSIONS:Patients with AP on CP have less severe disease than do those with AP without CP. Weight loss, advanced age, and comorbidity increase the risk of severity in patients with AP on CP.

journal_name

Pancreas

journal_title

Pancreas

authors

Akshintala VS,Hutfless SM,Yadav D,Khashab MA,Lennon AM,Makary MA,Hirose K,Andersen DK,Kalloo AN,Singh VK

doi

10.1097/MPA.0b013e3182a85af3

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

1245-50

issue

8

eissn

0885-3177

issn

1536-4828

pii

00006676-201311000-00008

journal_volume

42

pub_type

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