Mortality risk factors in chronic pancreatitis.

BACKGROUND

Mortality in chronic pancreatitis is higher than in the general population, the 10-year survival after diagnosis is estimated between 69-80%.

AIM

Evaluation of mortality risk factors in chronic pancreatitis.

MATERIAL AND METHOD

Eighty-two patients with chronic pancreatitis were followed-up for an average period of 25 months (median 25 months). None of them had an endoscopic treatment before inclusion in this study. The average age of the patients was 48 years (range 29 to 78, median 49), the ratio men:women being 6.5:1. The etiology was alcoholic in 84.2 % cases, pancreas divisum in 8.5% cases and idiopathic in 7.3% of cases.

RESULTS

During the follow-up period the mortality rate was 17%, death occurring at on average 59 months (median 53 months) from the onset of the disease. The most frequent causes of death were: pancreatic cancer (3.6%), complications after surgery (3.6%) and upper digestive hemorrhage (2.4%). The mortality risk factors were presence of diabetes, no alleviation of pain under treatment and unceasing of smoking. The type of treatment applied did not influence survival. The cumulative survival rate estimated at 3 years was 80% and at 5 years 59%.

CONCLUSIONS

The mortality rate in chronic pancreatitis was higher than those reported in the literature. Death caused by pancreatic cancer occurred in 3.6 % of the patients. There were no cases of death due to extra pancreatic cancers. The mortality risk factors were unceasing of smoking, no alleviation of pain under treatment and presence of diabetes.