Acute Pancreatitis in the Guangdong Province, China

Abstract

Background/Aims: Many studies have recently been published on acute pancreatitis; however, few large-sample studies have been focused on the risk factors for deaths in severe acute pancreatitis. To address this issue, the present study was intended to assess etiology, severity, and mortality of acute pancreatitis in the Guangdong Province (Guangdong), China, and to analyze the risk factors responsible for deaths in severe acute pancreatitis in this large series of patients. Methods: Four tertiary medical centers located in Guangdong were involved in this retrospective study. Data of 2,342 patients with acute pancreatitis admitted to these centers from December 1990 through December 2005 were collected in a standardized form and analyzed. Results: Of the 2,342 patients (1,130 men and 1,212 women, mean age 51±18, range 4–98 years), 1,778 (76.0%) had mild pancreatitis, and 564 (24.0%) had the severe form. Biliary tract disease (47.5%) was the predominant etiology, the overall mortality rate was 5.0%, and the fatality rate in patients with severe acute pancreatitis was 20.0%. Among the deceased patients in the severe acute pancreatitis group, logistic regression analysis of variables showed that the independent risk factor for mortality was shock, while a biliary origin was a protective factor against a poor prognosis. Conclusions: In this case series, the results suggest that biliary tract disease was the main etiologic factor of acute pancreatitis in Guangdong. The majority of deaths in severe acute pancreatitis occurred within the first 14 days of admission; the only independent risk factor for mortality was systematic complication of shock.

Severity, Treatment, and Outcome of Acute Pancreatitis in Thailand: The First Comprehensive Review Using Revised Atlanta Classification

“…The etiology of AP in this study was comparable with that in other studies from Asia [12, 13], with the leading causes of AP being gallstones and alcohol-related disease. However, gallstones were more prevalent in female, while alcohol was so in male, of which were well known.…”

“…The age and sex of the patients with AP in this study were very similar to those of patients in recent studies from the West [11] and Japan [12]; however, the mean age was slightly higher than that in a study from China [13, 14]. The typical clinical presentation was abdominal pain in almost all patients.…”

Nosocomial mortality and early prediction of patients with severe acute pancreatitis

“…The natural course of SAP progresses in two phases: Comorbid systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) due to the release of a large amount of cytokine in the early phase, and infection of pancreatic necrosis and secondary MODS in the late phase. Both contribute to considerable morbidity/mortality varying from 7% to 42% 3–6 . Tsui in his study indicated that the mortality of SAP in Nankai hospital was 9.23% between January 2000 and April 2008 7 …”

“…Both contribute to considerable morbidity/mortality varying from 7% to 42%. [3][4][5][6] Tsui in his study indicated that the mortality of SAP in Nankai hospital was 9.23% between January 2000 and April 2008. 7 There are a number of scoring systems to assess the severity of AP.…”

The Effect of Renin Angiotensin System Genetic Variants in Acute Pancreatitis

“…It is a common disease (current UK incidence: 150–420 cases per million per annum) and increasingly prevalent. 1 However, despite recent improvements in intensive care unit management and techniques of organ support, the severity and mortality associated with AP has not decreased since the 1970s 1 : up to 25% of patients will be diagnosed with severe disease 2–5 and approximately 4% of all patients will die. 6,7 This can be partly explained by the fact that no specific prophylactic or therapeutic agent is available, and current management is largely supportive.…”