Comparison of clinical characteristics and outcomes between alcohol-induced and gallstone-induced acute pancreatitis: An Australian retrospective observational study

Abstract

Objectives: To compare the characteristics and outcomes of patients presenting to hospital with alcohol-induced and gallstone-induced acute pancreatitis. Methods: Retrospective study of all patients with alcohol-induced or gallstone-induced pancreatitis during the period 1 June 2012 to 31 May 2016. The primary outcome measure was hospital mortality. Secondary outcome measures included hospital length of stay, requirements for intensive care unit admission, intensive care unit mortality, mechanical ventilation, renal replacement therapy, requirement of inotropes and total parenteral nutrition. Results: A total of 642 consecutive patients (49% alcohol; 51% gallstone) were included. No statistically significant differences were found between alcohol-induced and gallstone-induced acute pancreatitis with respect to hospital mortality, requirement for intensive care unit admission, intensive care unit mortality and requirement for mechanical ventilation, renal replacement therapy, inotropes or total parenteral nutrition. There was significant difference in hospital length of stay (3.07 versus 4.84; p < 0.0001). On multivariable regression analysis, Bedside Index of Severity in Acute Pancreatitis score (estimate: 0.393; standard error: 0.058; p < 0.0001) and admission haematocrit (estimate: 0.025; standard error: 0.008; p = 0.002) were found to be independently associated with prolonged hospital length of stay. Conclusion: Hospital mortality did not differ between patients with alcohol-induced and gallstone-induced acute pancreatitis. The duration of hospital stay was longer with gallstone-induced pancreatitis. Bedside Index of Severity in Acute Pancreatitis score and admission haematocrit were independently associated with hospital length of stay.

A study on demographic and clinicopathological characteristics of severe acute pancreatitis in a tertiary-level intensive care unit in Nepal

“…6 In this study, the patient's age range was17 to 90 years with the mean age of presentation being 49.03 years. Yadav et al, Das et al, and Reid et al showed a maximum age of 80 years while Alkareemy et al, showed…”

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Acute pancreatitis in Australian adults: can administrative data help with healthcare planning?

“…More recently, Australian data from 642 consecutive patients with AP found 51% were due to gallstones and 49% due to alcohol. 3 This current study has used AIHW data based on ICD-10-AM coding, which has its own limitations. Specifically, 'Unspecified' AP may be an umbrella code for several aetiologies including autoimmune, viral, hypertriglyceridemia, traumatic, and post ERCP.…”

“…There are limited epidemiological studies on the incidence of acute and chronic pancreatitis in Australia and New Zealand, with many retrospective cohort studies performed across Australasia evaluating the severity and management of AP rather than its incidence. [3][4][5] While demographic data from these studies can be extrapolated, formal epidemiological data are often lacking. This study is the largest population based study performed of its kind in the region, highlighting the rising incidence of AP across Australia.…”

“…There may be under‐utilization of USS in the work up of AP, with 25.6% of patients not having an USS in one study, 4 leaving a question whether this lead to the under‐diagnosis of a biliary aetiology. More recently, Australian data from 642 consecutive patients with AP found 51% were due to gallstones and 49% due to alcohol 3 . This current study has used AIHW data based on ICD‐10‐AM coding, which has its own limitations.…”