Clinical features of elderly patients with acute pancreatitis aged ≥80 years

Jin XU; Xin JIANG; Yongfeng YAN; Rui ZHONG; Yan PENG; Xiaowei TANG; Chuankang TANG

doi:10.3969/j.issn.1001-5256.2021.01.028

Volume 37 Issue 1

Jan. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2021 > 37(1): 142-146

PDF( 2055 KB)

Clinical features of elderly patients with acute pancreatitis aged ≥80 years

DOI: 10.3969/j.issn.1001-5256.2021.01.028

Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China

Received Date: 2020-07-14
Accepted Date: 2020-08-08
Published Date: 2021-01-20

Abstract

Abstract

Objective To investigate the clinical features of elderly patients with acute pancreatitis (AP) aged ≥80 years. Methods A retrospective analysis was performed for 3642 patients with pancreatitis who were admitted to Department of Gastroenterology in The Affiliated Hospital of Southwest Medical University from January 2013 to December 2019, and according to age, they were divided into young group (aged < 65 years) with 2955 patients, middle-aged group (aged 65-79 years) with 558 patients, and elderly group (aged ≥80 years) with 129 patients. Related clinical data were collected and analyzed, including sex, age, etiology, predisposing factors, past medical history, disease severity, complication, and clinical outcome. The independent samples one-way ANOVA-test was used for comparison of normally distributed continuous data between groups and the least significant difference t-test was used for comparison within each group; the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups; the Kruskal-Wallis H test was used for comparison of ordinal categorical variables. Results In the young group, there were 1721 male patients and 1234 female patients; in the middle-aged group, there were 214 male patients and 334 female patients; in the elderly group, there were 48 male patients and 81 female patients; the middle-aged group and the elderly group had a significantly higher proportion of female patients than the young group (62.8% vs 61.6% vs 41.8%, P < 0.05). High-fat diet was the main predisposing factor for all three groups, and compared with the young group, the elderly group had a significantly lower proportion of patients with AP induced by alcohol or high-fat diet+alcohol (P < 0.05). The elderly group had a significantly higher proportion of patients with the etiology of biliary diseases than the middle-aged group and the young group (79.8% vs 69.2% vs 41.4%, χ²=204.127, P < 0.05), as well as a significantly lower proportion of patients with the etiology of hyperlipidemia, alcohol, or biliary diseases+hyperlipidemia (all P < 0.05). Among the 129 patients in the elderly group, 83 (64.3%) had mild AP, 23 (17.8%) had moderate-severe AP, and 23 (17.8%) had severe AP; there was a significant difference in the constituent ratio of disease severity between the elderly group and the middle-aged/young groups (H=1972.5, P < 0.05). The elderly group and the middle-aged group had a significantly lower proportion of patients with recurrence than the young group (both P < 0.05). There were no significant differences in local complications between the three groups (all P > 0.05), and as for systemic complications, compared with the young group, the elderly group had a significantly higher proportion of patients with pneumonia (3.9% vs 2.2%, P < 0.05), acute kidney injury (AKI) (6.2% vs 2.5%, P < 0.05), or multiple organ dysfunction syndrome (MODS) (7.8% vs 4.0%, P < 0.05). Compared with the middle-aged group and the young group, the elderly group had a significantly lower proportion of cured patients (67.4% vs 76.3% vs 82.0%, P < 0.05) and a significantly higher proportion of patients with improvement (23.3% vs 14.7%/12.7%, P < 0.05). The elderly group and the middle-aged group had a significantly higher proportion of patients withdrawn from treatment than the young group (8.5%/5.9% vs 3.4%, P < 0.05). There was 1 death in the elderly group (0.8%), 9 deaths in the middle-aged group (1.6%), and 16 deaths in the young group (0.5%), and there was no significant difference between the three groups (P > 0.05). There were no significant differences in length of hospital stay and hospital costs between the three groups (P > 0.05). Conclusion AP patients aged ≥80 years are mainly female and are often caused by biliary factors, and they are likely to develop the complications such as pneumonia, AKI, and MODS.
- Pancreatitis,
- Aged,
- Disease Attributes

FullText(HTML)

References(23)

References

[1]	LEPPÄNIEMI A, TOLONEN M, TARASCONI A, et al. 2019 WSES guidelines for the management of severe acute pancreatitis[J]. World J Emerg Surg, 2019, 14: 27. DOI: 10.1186/s13017-019-0247-0
[2]	SANDZÉN B, ROSENMVLLER M, HAAPAMÄKI MM, et al. First attack of acute pancreatitis in Sweden 1988-2003: Incidence, aetiological classification, procedures and mortality-a register study[J]. BMC Gastroenterol, 2009, 9: 18. DOI: 10.1186/1471-230X-9-18
[3]	ROBERTS SE, MORRISON-REES S, JOHN A, et al. The incidence and aetiology of acute pancreatitis across Europe[J]. Pancreatology, 2017, 17(2): 155-165. DOI: 10.1016/j.pan.2017.01.005
[4]	BANKS PA, BOLLEN TL, DERVENIS C, et al. Classification of acute pancreatitis-2012: Revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111. DOI: 10.1136/gutjnl-2012-302779
[5]	VLGER BV, GVL M, USLUKAYA Ö, et al. New hormones to predict the severity of gallstone-induced acute pancreatitis[J]. Turk J Gastroenterol, 2014, 25(6): 714-717. http://europepmc.org/abstract/med/25599787
[6]	SCHERER J, SINGH VP, PITCHUMONI CS, et al. Issues in hypertriglyceridemic pancreatitis: An update[J]. J Clin Gastroenterol, 2014, 48(3): 195-203. DOI: 10.1097/01.mcg.0000436438.60145.5a
[7]	GAO YJ, LI YQ, WANG Q, et al. Analysis of the clinical features of recurrent acute pancreatitis in China[J]. J Gastroenterol, 2006, 41(7): 681-685. DOI: 10.1007/s00535-006-1820-3
[8]	KOWALP, GOODKINDD, HEW. (2016) An Aging World: 2015, International Population Reports. U.S[EB/OL]. http://www.census.gov/library/publications/2016/demo/P95-16-1.html.
[9]	CLEGG A, YOUNG J, ILIFFE S, et al. Frailty in elderly people[J]. Lancet, 2013, 381(9868): 752-762. DOI: 10.1016/S0140-6736(12)62167-9
[10]	ZHU Y, PAN X, ZENG H, et al. A study on the etiology, severity, and mortality of 3260 patients with acute pancreatitis according to the Revised Atlanta Classification in Jiangxi, China over an 8-year period[J]. Pancreas, 2017, 46(4): 504-509. DOI: 10.1097/MPA.0000000000000776
[11]	QUERO G, COVINO M, OJETTI V, et al. Acute pancreatitis in oldest old: A 10-year retrospective analysis of patients referred to the emergency department of a large tertiary hospital[J]. Eur J Gastroenterol Hepatol, 2020, 32(2): 159-165. DOI: 10.1097/MEG.0000000000001570
[12]	Editoral Board of Chinese Journal of Digestion, Cooperation Group of Hepatobiliary Disease of Chinese Society of Gastroenterology. Consensus on diagnosis and treatment of chronic cholecystitis and gallstones in China (2018)[J]. J Clin Hepatol, 2019, 35(6): 1231-1236. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.06.011 中华消化杂志编辑委员会, 中华医学会消化病学分会肝胆疾病协作组. 中国慢性胆囊炎、胆囊结石内科诊疗共识意见(2018年)[J]. 临床肝胆病杂志, 2019, 35(6): 1231-1236. DOI: 10.3969/j.issn.1001-5256.2019.06.011
[13]	TAI WP, ZHANG NW, ZHU B, et al. Clinical characteristics and diagnosis and treatment efficiency of acute pancreatitis in the elderly[J]. Chin J Mult Organ Dis Elderly, 2018, 17(1): 57-60. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLQG201801015.htm 台卫平, 张能维, 朱斌, 等. 老年急性胰腺炎患者的临床特征和诊疗效果分析[J]. 中华老年多器官疾病杂志, 2018, 17(1): 57-60. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLQG201801015.htm
[14]	BARBEIRO DF, KOIKE MK, COELHO AM, et al. Intestinal barrier dysfunction and increased COX-2 gene expression in the gut of elderly rats with acute pancreatitis[J]. Pancreatology, 2016, 16(1): 52-56. DOI: 10.1016/j.pan.2015.10.012
[15]	CARVALHO JR, FERNANDES SR, SANTOS P, et al. Acute pancreatitis in the elderly: A cause for increased concern?[J]. Eur J Gastroenterol Hepatol, 2018, 30(3): 337-341. DOI: 10.1097/MEG.0000000000001028
[16]	MIN A, LI H, XIANG HP, et al. Comparison of three classification systems for acute pancreatitis[J]. Chin J Emerge Med, 2019, 28(5): 625-629. (in Chinese) DOI: 10.3760/cma.j.issn.1671-0282.2019.05.018 闵安, 李贺, 项和平, 等. 急性胰腺炎三种分类标准的比较[J]. 中华急诊医学杂志, 2019, 28(5): 625-629. DOI: 10.3760/cma.j.issn.1671-0282.2019.05.018
[17]	JIANG X, XU H, YAN YF, et al. Clinical and prognostic characteristics of alcoholic pancreatitis[J]. J Clin Hepatol, 2019, 35(11): 2528-2532. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.11.027 蒋鑫, 徐欢, 严永峰, 等. 酒精性急性胰腺炎的临床及预后特征分析[J]. 临床肝胆病杂志, 2019, 35(11): 2528-2532. DOI: 10.3969/j.issn.1001-5256.2019.11.027
[18]	TANG YL, FANG CG, WU WW, et al. Analysis of high risk factors and predictive models of secondary pancreatic necrosis in acute biliary pancreatitis[J]. Trauma and Crit Medicine, 2020, 8(2): 104-106, 109.(in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-CSJB202002012.htm 唐义龙, 方晨光, 吴文伟, 等. 急性胆源性胰腺炎继发胰腺坏死高危因素及预测模型分析[J]. 创伤与急危重病医学, 2020, 8(2): 104-106, 109. https://www.cnki.com.cn/Article/CJFDTOTAL-CSJB202002012.htm
[19]	LÖHR JM, PANIC N, VUJASINOVIC M, et al. The ageing pancreas: A systematic review of the evidence and analysis of the consequences[J]. J Intern Med, 2018, 283(5): 446-460. DOI: 10.1111/joim.12745
[20]	SHEN XZ, WU SD. Pathogenesis and progress of diagnosis and treatment of severe acute pancreatitis-associated kidney injury[J]. Chin J Dig, 2019, 39(5): 300-303. (in Chinese) DOI: 10.3760/cma.j.issn.0254-1432.2019.05.005 沈锡中, 吴盛迪. 重症急性胰腺炎相关肾损伤的发病机制和诊疗进展[J]. 中华消化杂志, 2019, 39(5): 300-303. DOI: 10.3760/cma.j.issn.0254-1432.2019.05.005
[21]	PATEL K, LI F, LUTHRA A, et al. Acute biliary pancreatitis is associated with adverse outcomes in the elderly: A propensity score-matched analysis[J]. J Clin Gastroenterol, 2019, 53(7): e291-e297. DOI: 10.1097/MCG.0000000000001108
[22]	KOZIEL D, GLUSZEK-OSUCH M, SULIGA E, et al. Elderly persons with acute pancreatitis - specifics of the clinical course of the disease[J]. Clin Interv Aging, 2019, 14: 33-41. http://www.researchgate.net/publication/329820494_Elderly_persons_with_acute_pancreatitis_-_specifics_of_the_clinical_course_of_the_disease
[23]	MÁRTA K, LAZARESCU AM, FARKAS N, et al. Aging and comorbidities in acute pancreatitis I: A Meta-analysis and systematic review based on 194, 702 patients[J]. Front Physiol, 2019, 10: 328. DOI: 10.3389/fphys.2019.00328

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Tables(5)

Get Citation

PDF

XML

Article Metrics

Article views (910) PDF downloads(48)

Clinical features of elderly patients with acute pancreatitis aged ≥80 years

DOI: 10.3969/j.issn.1001-5256.2021.01.028

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content