<p>The Clinical Characteristics of Acute Pancreatitis in Gerontal Patients: A Retrospective Study</p>

Abstract

Background The incidence of acute pancreatitis (AP) in ageing patients has increased in recent years, and results regarding the clinical outcomes of these patients are controversial. The aim of this study was to compare the clinical outcomes of AP in ageing patients over 60 years old. Methods Eighty patients aged ≥80 years (oldest group) were compared to 393 patients aged 60 to 79 years (older group). The clinical course and biochemical and radiological data were evaluated. The primary endpoints were mortality rate, intensive care unit (ICU) admission rate and in-hospital length of stay (LOS). The secondary endpoints were the incidence of operative treatment and complications of AP. Results Abdominal pain (61.3% vs 46.3%, P=0.013) was less common in the oldest group. Jaundice (17.5% vs 8.9%, P=0.021) and dyspnoea (26.3% vs 11.5%, P=0.001) were more obvious in the oldest group than in the older group. The mean BMI was lower in the oldest group than in the older group (21.07±3.18 vs 22.36±2.89, P = 0.001). Age over 80 years (P=0.011) and organ failure (P<0.05) were independent risk factors for mortality. More severe AP (P=0.001), abdominal pain (P=0.033) and organ failure (P<0.05) were associated with the ICU admission rate. Age over 80 years (P=0.001), more severe AP (P=0.001), female sex (P=0.018), jaundice (P=0.038), operative treatment (P<0.05) and organ failure (P<0.05) were risk factors for increased LOS. Conclusion The oldest group had a higher death rate and longer LOS than the older group. More attention should be given to the clinical symptoms of this frail population. We propose that more comprehensive and goal-directed attendant diagnostic procedures should be performed to detect the disease early and to improve the outcomes of ageing patients.

Clinical characteristics and risk factors of organ failure and death in necrotizing pancreatitis

“…In terms of etiology, biliary-induced pancreatitis is considered to be the rst etiological factor of AP in China, especially in the elderly who have a much larger diameter of the bile duct and higher incidence of gallstones [27,36,[46][47][48]. Despite such a enormous base of the biliary causes, only one-sixth of the elderly in our NP data made the proportion of biliary sources rank the second.…”

“…Local complications including WON, ANC, PP and APFC were diagnosed by contrast-enhanced computed tomography (CECT) [2,27]. NP is diagnosed on contrast-enhanced cross-sectional imaging as the absence of pancreatic or peripancreatic enhancement.…”

Clinical characteristics and risk factors of organ failure and death in necrotizing pancreatitis

“…Local complications including WON, ANC, PP and APFC were diagnosed by contrast-enhanced computed tomography (CECT) [ 2 , 29 ]. NP is diagnosed on contrast-enhanced cross-sectional imaging as the absence of pancreatic or peripancreatic enhancement.…”

Acute Pancreatitis in Elderly Patients

“…The global incidence rate of AP is increasing. 1 It is reported in 34 per 100,000 inhabitants. Elderly populations have also seen an increase in AP.…”

“…Abdominal pain, the cardinal symptom of AP, is absent or mild in 53.7% of cases, perhaps because of neuropathy, greater pain tolerance, or fibrosis of the perineurium due to aging. 1 Fever and leukocytosis are often absent, and a confusional state with rapid development of shock may be found. The elderly also show more frequently increased serum creatinine levels 10 and decreased serum albumin and hemoglobin levels.…”