Prognosis of chronic pancreatitis: An international multicenter study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Albert B. Lowenfels
  • Patrick Maisonneuve
  • Giorgio Cavallini
  • Rudolf W
  • Paul G. Lankisch
  • Andersen, Jens Rikardt
  • Eugene P. DiMagno
  • Åke Andrén‐Sandberg
  • Lennart Domellöf
  • Vincenzo Di Francesco
  • Paolo Pederzoli
  • Annette Lühr‐Happe
  • Einar Krag
  • Peter Boyle
  • C. S. Pitchumoni
  • Pe Shein Wynn
  • L. Joseph Melton

Objectives: Tbe aim of this study was to determine which factors predict mortality in a cobort of patients with cbronic alcoholic and nonalcoholic pancreatitis. Patients with chronic pancreatitis are known to have a reduced life expectancy, but the quantitative relationship between various clinical features and survival is unclear. 

Methods: We evaluated survival among 2015 subjects with chronic pancreatitis treated at seven centers located in six countries. 

Results: Mean age at diagnosis was 46 ± 13 yr and mean duration of follow‐up was 7.4 ± 6.2 yr. Overall survival at 10 yr was 70% (95% confidence interval (CI), 68–73%) and at 20 yr was 45% (95% CI, 41–49%). Survival was significantly less than in the background population. There were 559 deaths observed among those with chronic pancreatitis compared with an expected number of 157.4, yielding a standardized mortality ratio (SMR) of 3.6 (95% CI, 3.3–3.9). Older subjects and those with alcoholic pancreatitis had a significant reduction in survival. In a mul‐tivariate analysis, mortality of middle‐aged and older subjects was 2.3 (95% CI, 1.8–2.8) and 6.3 (95% CI, 4.7–8.3) times greater than subjects less than 40 yr at diagnosis. Smoking (hazard ratio, 1.4; 95% CI, 1.0–1.9), drinking (hazard ratio, 1.6; 95% CI, 1.2–2.2), or development of cirrhosis (hazard ratio, 2.5; 95% CI, 2.0–3.2) increased the risk of death during the observation period, but we observed no survival difference in operated vs. nonoperated patients. 

Conclusions: Age at diagnosis, smoking, and drinking are major predictors of mortality in patients with chronic pancreatitis.

TidsskriftThe American Journal of Gastroenterology
Udgave nummer9
Sider (fra-til)1467-1471
Antal sider5
StatusUdgivet - sep. 1994
Eksternt udgivetJa

Bibliografisk note


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