[Severity analyese of acute pancreatitis based on etiology].

OBJECTIVE

To explore the relationship between etiology and severity of acute pancreatitis (AP).

METHODS

A total of 486 AP patients, hospitalized at digestive, general surgery or critical care medicine departments from May 2012 to May 2014, were recruited retrospectively. And the data of clinical features, etiology and severity classification of AP according to the revised Atlanta criteria (2012) were collected. The relationships between different gender, age group, etiology and severity of disease were compared.

RESULTS

The etiology distribution was as follows: gallstone (n = 296, 60.9%), hyperlipidemia (n = 93, 19.1%), alcohol (n = 48, 9.9%) and other causes (n = 49, 10.1%). And the severity was mild AP (MAP, n = 387, 79.6%), moderate-severe AP (MSAP, n = 53, 10.9%) and severe AP (SAP, n = 46, 9.5%). The proportion of females for gallstone AP was slightly higher than that of males (1.23: 1). However, for hyperlipidemic and alcoholic AP, the proportion of males was significantly higher than that of females (P = 0.00). The onset age of gallstone AP was generally over 40 years while hyperlipidemic and alcoholic AP tended to occur in patients aged under 60 years (P = 0.00). Among all age groups, the group of over 60 years had the highest MSAP incidence of 14% while <40-year-old group the highest incidence of SAP at 11.3%. And the >60-year-old group had the highest total incidence of MSAP and SAP at 22.2%. Compared with gallstone, alcohol and other causes, hyperlipidemic AP had a higher risk of MSAP and SAP (P = 0.028).

CONCLUSION

Gallstone remains a leading cause of AP. Hyperlipidemic pancreatitis has shown a rising tendency in recent years and it often result in a more serious clinical process. And the clinicians should pay more attention to health education of patients.