A single-centre prospective, cohort study of the natural history of acute pancreatitis. Issue 3 (March 2015)

• Record Type: Journal Article
• Authors: Cavestro, Giulia Martina; Leandro, Gioacchino; Di Leo, Milena; Zuppardo, Raffaella Alessia; Morrow, Olivia B.; Notaristefano, Chiara; Rossi, Gemma; Testoni, Sabrina Gloria Giulia; Mazzoleni, Giorgia; Alessandri, Matteo; Goni, Elisabetta; Singh, Satish K.; Giliberti, Aurore; Bianco, Margherita; Fanti, Lorella; Viale, Edi; Arcidiacono, Paolo Giorgio; Mariani, Alberto; Petrone, Maria Chiara; Testoni, Pier Alberto
• Is Part Of: Digestive and liver disease. Volume 47:Issue 3(2015)
• Page Start: 205
• Page End: 210
• Publication Date: 2015-03
• Subjects: Acute pancreatitis -- Alcohol and smoking habits -- Chronic pancreatitis -- Pancreas divisum -- Recurrent acute pancreatitis -- Severe acute disease; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2014.11.003
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: The natural history of acute pancreatitis is based on clinical studies that aim to elucidate the course of disease on the basis of predicted risk factors. Aims: To evaluate the long-term occurrence of recurrent acute pancreatitis and chronic pancreatitis in a cohort of patients following an initial episode of acute pancreatitis. Methods: 196 patients were enrolled consecutively and studied prospectively. Clinical characteristics, exogenously/endogenously-associated factors, and evolution to recurrent acute pancreatitis and chronic pancreatitis were analyzed. Results: 40 patients developed recurrent acute pancreatitis 13 of whom developed chronic pancreatitis. In a univariate analysis, recurrent acute pancreatitis was associated with an idiopathic aetiology ( p < 0.001), pancreas divisum ( p = 0.001), and higher usage of cigarettes and alcohol ( p < 0.001; p = 0.023). Chronic pancreatitis was associated with a severe first episode of acute pancreatitis ( p = 0.048), PD ( p = 0.03), and cigarette smoking ( p = 0.038). By multivariate analysis, pancreas divisum was an independent risk factor for recurrent acute pancreatitis (OR 11.5, 95% CI 1.6–83.3). A severe first-episode of acute pancreatitis increased the risk of progressing to chronic pancreatitis by nine-fold. Conclusions: Special attention should be given to patients who experience a severe first attack of acute pancreatitis as there appears to be an increased risk of developing chronic pancreatitis over the long term.