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 cigarette. s 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.

A single-centre prospective, cohort study of the natural history of acute pancreatitis / Cavestro, Gm; Leandro, G; Di Leo, M; Zuppardo, Ra; Morrow, Ob; Notaristefano, C; Rossi, G; Testoni, Sg; Mazzoleni, G; Alessandri, M; Goni, E; Singh, Sk; Giliberti, A; Bianco, M; Fanti, L; Viale, E; Arcidiacono, P. G.; Mariani, A; Petrone, Mc; Testoni, Pa.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 47:3(2015), pp. 205-210. [10.1016/j.dld.2014.11.003]

A single-centre prospective, cohort study of the natural history of acute pancreatitis

Cavestro GM;Arcidiacono P.G.;
2015-01-01

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 cigarette. s 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.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/95727
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