Progression to recurrent acute pancreatitis after a first attack of acute pancreatitis in adults |
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| Affiliation: | 1. Department of Diagnostic Radiology, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata-shi, Yamagata, 990-9585, Japan;2. Department of Radiology, Yamagata University Hospital, Japan;3. Department of Gastroenterology, Faculty of Medicine, Yamagata University, Japan;1. Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China;2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China;3. Shanghai Pancreatic Cancer Institute, Shanghai, 200032, China;4. Pancreatic Cancer Institute, Fudan University, Shanghai, 200032, China;1. Cedars Sinai Cancer, Cedars-Sinai Medical Center, Los Angeles, CA, USA;2. Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA;3. Center for Research on Healthcare Data Center, University of Pittsburgh, Pittsburgh, PA, USA;4. Mercy Clinic Gastroenterology, St. Louis, MO, USA;5. Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;6. Aurora St. Luke’s Medical Center, Milwaukee, WI, USA;7. Gastroenterology Associates, Richmond, VA, USA;8. Pancreatitis Center, Division of Gastroenterology, Johns Hopkins Medical Institutions, Baltimore, MD, USA;9. Division of Gastroenterology and Hepatology, University of Alabama Birmingham, AL, USA;1. Division of Gastroenterology, Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA;2. Saint Peter''s University Hospital/Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, USA;3. Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA;4. Division of Gastroenterology, Mayo Clinic, Jacksonville, FL, USA |
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| Abstract: | PurposePatients with a first attack of acute pancreatitis (AP) can develop recurrent acute pancreatitis (RAP). Hence, this study aimed to investigate the clinical features of the disease and the risk factors for RAP.MethodsWe performed a retrospective study of 522 patients from Jan 1 to Dec 31, 2006. All patients with AP were followed for 36 months. The primary end point was the rate of RAP. The secondary end points were the risk factors that were evaluated by Cox regression analysis. The cumulative risk of RAP was assessed using Kaplan-Meier analysis.Results56 of the 522 patients (10.7%) developed RAP. Among those RAP patients, 37 (7.1%) experienced one relapse, 10 (1.9%) experienced two relapses, and 9 (1.7%) experienced three or more relapses. Univariate analysis indicated that age (p = 0.016), male sex, etiology of AP (p = 0.001), local complications (p = 0.001) and Length of stay (LOS) (p = 0.007) were associated with RAP. Multivariate analysis with the Cox proportional hazards model showed that male sex (HR = 2.486, 95% CI, 0.169–0.960, p = 0.04), HTG-associated etiology (HR = 5.690, 95% CI, 2.138–15.146, p = 0.001), alcohol-associated etiology (HR = 5.867, 95% CI, 1.446–23.803, p = 0.013) and current local complications at index admission (HR = 8.917, 95% CI, 3.650–21.789, p = 0.001) were significant independent risk factors for RAP.ConclusionsA first attack of AP led to RAP in 10.7% of patients within 3 years. Male sex was significantly associated with RAP. The etiologies of alcohol and HTG and local complications were the strongest risk factors for recurrent disease. Patients with these characteristics should be given special attention and followed-up closely. |
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| Keywords: | Acute pancreatitis Recurrent acute pancreatitis Incidence rate Risk factor Etiology |
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