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Clinical and CT/MRI imaging features of acute pancreatitis in older people
Xue Ying Zhang1,2, Xing Hui Li1, Jiang Luo1
1Medical Imaging Key Laboratory of Sichuan Province, Department of Radiology, Affiliated Hospital, North Sichuan Medical College, No.1 South Maoyuan Road, Nanchong, Sichuan, 637001, China.
Background:
In recent years, the incidence of acute pancreatitis (AP) in the older people has been increasing. Some reports indicate that AP in the older people, is clinically more severe and systemic complications more frequent, leading to higher mortality compared to younger individuals. The clinical and CT/MRI features of senile AP are insufficient and the results are inconsistent. The purpose of this study was to investigate the clinical features, CT/MRI imaging characteristics, and prognosis of AP in older people based on age stratification.
Methods:
We collected clinical and imaging (CT/MRI) data from 449 older people with AP and categorized them into three age groups: aged 65 ~ 74 (young old, group 1), 75 ~ 84 (middle old, group 2), and ≥ 85 years (oldest old, group 3). Their clinical presentation, imaging characteristics, and clinical outcome endpoints were identified and compared.
Results:
The average age was 73 (69,78) years, with 259 (57.7%) being female. On CT/MRI, Group 3 had the highest prevalence of local complications and the probability of acute peripancreatic fluid collection (APFC). Group 3 had the highest SIRS, BISAP, and APACHE-Ⅱ scores. Group 3 had the highest prevalence of coronary heart disease, organ failure (OF), severe pancreatitis (SAP), and the highest mortality rate. OF, SAP, and APFC were independent risk factors for mortality (p < 0.05).
Conclusions:
Different age subgroups in older people with AP have different CT/MRI imaging and clinical features and prognoses. Group 3 had a higher prevalence of local complications and APFC, higher clinical scores, more severe clinical progression, and worse clinical prognosis.
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