Influence of advanced age and related comorbidity on the course and outcome of acute pancreatitis.

BACKGROUND AND AIMS

Aging process and comorbidity have been held to influence the course and outcome of acute pancreatitis in elderly patients. The aim of the present study was to investigate this issue in a large series of patients > or = 70 years of age suffering from acute pancreatitis.

PATIENTS AND METHODS

A retrospectively study was carried out on 439 patients with a first episode of AP. The patients were divided into two age groups: < or = 69 years (n = 340) and > or = 70 years (n = 99). Differences in general characteristics, aetiological factors, blood tests and laboratory data, severity of the disease and outcome were evaluated. The presence of intercurrent diseases was also investigated in the two age groups.

RESULTS

No significant difference was observed in the distribution of the various aetiological factors in the two age groups considered. The percentage of patients with necrotizing forms of AP, Ranson prognostic score for severity, local and systemic complications, the number of patients requiring surgical intervention or endoscopic sphincterotomy, as well as length of hospital stay were similar in the two groups. Considering the patients suffering from necrotizing acute pancreatitis, a significant increase (p = 0.01) in mortality was observed in > or = 70-year-old patients (25.8 vs 7.8%). Associated diseases were significantly more frequent in advanced age (63.6 vs 41.4%; p = 0.0004), but comorbidity did not correlate with the presence of pancreatic necrosis, the need for surgery or endoscopic sphincterotomy, and with mortality.

CONCLUSIONS

The results of this study suggest that advanced age and related comorbidity have only a limited influence on the course and outcome of acute pancreatitis.