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Acute pancreatitis in patients over 80 years
H Paajanen1, M Jaakkola, H Oksanen
1Department of Surgery, Kuopio University Hospital, Finland.
Objective:
To evaluate the occurrence, aetiology and outcome of acute pancreatitis (AP) in patients over 80 years of age, compared with those between 61 and 79 years old.
Design:
Retrospective analysis.
Setting:
University hospital, Finland.
Subjects:
Subgroups of 22 patients 80 years old or over and 139 patients 61-79 years old out of 1058 episodes of AP between 1982 and 1990.
Main Outcome Measures:
Mortality, morbidity, and hospital stay.
Results:
The percentage of patients aged 80 or more varied from 0 in 1982 to 3% in 1990; 13 (59%) were women compared with 47 (34%) in the 61-79 year old group (p = 0.03). AP in the older group was more likely to be necrotising 9/22 (41%) compared with 23/139 (17%), p = 0.02) and to have been caused by biliary disease 15/22 (68%) compared with 54/139 (39%), (p = 0.01). The overall mortality was 9/22 (41%) in the 80 years and over group and 24/139 (17%) in patients aged 61-79 years (p = 0.02). All 9 patients in their eighties with necrotising pancreatitis died. Neither the mode of treatment nor the Glasgow prognostic scoring had any relation to mortality in the older group.
Conclusions:
AP in patients of 80 or more is a serious disease with a high mortality irrespective of standard treatment.