Severe acute pancreatitis in the elderly: Etiology and clinical characteristics

Table 1 General clinical characteristics of patients with severe acute pancreatitis

	Elderly (≥60 yr)	Young (< 60 yr)	P
	(n = 94)	(n = 75)	value
Mean age (yr, range)	70.9 (60-87)	44.2 (17-59)	-
Male	44 (46.8%)	49 (65.3%)	0.0197
Female	50 (53.2%)	26 (34.7%)	0.0197
Medium ICU stay in days (range)	8 (2-56)	8 (2-90)	-
Medium hospital stay in days (range)	21 (13-64)	19 (12-90)	-
Hospital deaths	16 (17.0%)	4 (5.3%)	0.0291

Table 2 Etiology of severe acute pancreatitis n (%)

	Elderly (≥60 yr)	Young (< 60 yr)	P value
Biliary	61 (64.9)	28 (37.3)	0.0006
Alcohol	2 (2.1)	15 (20.0)	0.0001
Hyperlipemia	3 (3.2)	22 (29.3)	< 0.0001
Abdominal surgery	2 (2.1)	1 (1.3)	1
Drug-induced	1 (1.1)	0 (0.0)	1
Idiopathic	25 (26.6)	9 (12.0)	0.021
Total	94	75	-

Table 3 Co-morbidity of severe acute pancreatitis n (%)

	Elderly (≥60 yr)	Young (< 60 yr)	P value
Cholelithiasis	47 (50.0)	18 (24.0)	0.0008
Biliary infection	20 (21.3)	5 (6.7)	0.0087
Hypertension	20 (21.3)	4 (5.3)	0.0035
Coronary heart diseases	14 (14.9)	4 (5.3)	0.0490
Previous stroke	5 (5.3)	0 (0.0)	0.0667
Previous myocardial infarction	4 (4.3)	1 (1.3)	0.3836
Diabetes mellitus	8 (8.5)	9 (12.0)	0.6079
Liver cirrhosis	3 (3.2)	2 (2.7)	1.0000
Malignant diseases	4 (4.3)	1 (1.3)	0.3836
Autoimmune diseases	0 (0.0)	1 (1.3)	0.4438

Table 4 Clinical scoring of severe acute pancreatitis (mean ± SD)

	Elderly (≥60 yr, n = 94)	Young (< 60 yr, n = 75)	P value
Ranson	3.4 (1.7)	2.8 (1.6)	0.0069
APACHE II	14.0 (7.6)	9.9 (6.6)	0.0003
CT score	4.0 (1.9)	4.8 (1.8)	0.0020

Table 5 Organ failures and complications in severe acute pancreatitis n (%)

	Elderly (≥60 yr)	Young (< 60 yr)	P value
Total	94 (100)	75 (100)
ALI/ARDS	29 (30.9)	13 (17.3)	0.0498
Renal insufficiency	17 (18.1)	5 (6.7)	0.0375
Cardiovascular insufficiency	16 (17.0)	11 (14.7)	0.8331
Pancreastic encephalopathy	16 (17.0)	4 (5.3)	0.0291
Hepatic insufficiency	8 (8.5)	5 (6.7)	0.7754
Metabolic disorders	20 (21.3)	12 (16.0)	0.4334
DIC	5 (5.3)	4 (5.3)	1.0000
GI bleeding	5 (5.3)	5 (6.7)	0.7521
With single organ failure	42 (44.7)	16 (21.3)	0.0019
With MODS	25 (26.6)	10 (13.3)	0.0374
Pancreatic abscess	13 (13.9)	13 (17.3)	0.6685
Pancreatic pseudocyst	11 (11.7)	8 (10.7)	1.0000
Ileus	9 (9.6)	6 (8.0)	0.7909
ACS	5 (5.3)	4 (5.3)	1.0000
Fungous infection	4 (4.3)	1 (1.3)	0.3836
Sepsis	8 (8.5)	6 (8.0)	1.0000

ALI/ARDS: Acute lung injury or acute resparitory distress syndrome; MODS: Multiple organ dysfunction syndrome; GI: Gastrointestinal; ACS: Abdominal compartment syndrome; DIC: Disseminated intravascular coagulation.

Table 6 Clinical characteristics of dead and survived cases in the aged with severe acute pancreatitis n (%)

		Death (n = 16)	Survival (n = 78)	P value
Gender	Male	9 (56.3)	35 (44.9)	0.4255
	Famale	7 (43.7)	43 (55.1)	0.4255
Etiology	Biliary	10 (62.5)	51 (65.4)	1.0000
	Idiopathic	5 (31.3)	20 (25.6)	0.7570
Scoring	Ranson	5.6 ± 1.8	3.1 ± 1.3	< 0.0001
(mean ± SD)	APACHE II	26.3 ± 9.3	11.9 ± 4.7	< 0.0001
	CT score	5.6 ± 2.1	3.7±1.7	0.0001
Co-morbidity	Single	4 (25.0)	28 (35.9)	0.5647
	Multiple	12 (75.0)	24 (30.8)	0.0015
Organ dysfunction	Single	1 (6.3)	16 (20.5)	0.2882
	MODS	15 (93.8)	10 (12.8)	< 0.0001