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, G.m., Leandro, G., Di Leo, M., Zuppardo, R.a., Morrow, O.b., Notaristefano, C., Rossi, G., Testoni, S.g., Mazzoleni, G., Alessandri, M., Goni, E., Singh, S.k., Giliberti, A., Bianco, M., Fanti, L., Viale, E., Arcidiacono, P.G., Mariani, A., Petrone, M.c., 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;Testoni SG;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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
