The effect of age on hospital outcomes in severe acute pancreatitis

The role of age as an important independent risk factor in severe acute pancreatitis is debated. We evaluated clinical outcomes, including in-hospital mortality and long-term disease stigmata, in elderly patients admitted with severe acute pancreatitis.

We performed a retrospective case-control study in which cases were 56 elderly patients > or =70 years old and controls were 56 younger patients <70 years old. All patients were admitted to the Mayo Medical Center between 1992 and 2007 with severe acute pancreatitis, as defined by the Atlanta classification. The groups were matched for body mass index, medical comorbidities and etiology of pancreatitis. Both hospitalization and subsequent follow-up data were collected.

With the exception of age, the baseline characteristics of the two groups were similar. In-hospital mortality in the elderly was 3-fold greater than in controls (21.4 vs. 7.1%, p = 0.028), although length of stay was similar between the groups (26.9 vs. 31.0 days, p = 0.460). The development of organ failure, but not necrosis, was more frequent in the elderly group (64.3 vs. 48.2%, p = 0.043). There was no in-hospital mortality among patients without organ failure. The subsequent development of diabetes, recurrence of acute pancreatitis and incidence of post-hospitalization mortality was similar between groups.

Age > or =70 years is an independent risk factor for mortality in patients admitted with severe acute pancreatitis. and IAP.