AMOUNT OF ALCOHOL IS AN IMPORTANT DETERMINANT OF THE SEVERITY OF ACUTE ALCOHOLIC PANCREATITIS

Background. Does the amount of recently consumed alcohol correlate wit h the severity of acute alcoholic pancreatitis? Methods. One hundred o ne consecutive episodes of acute pancreatitis (AP) were prospectively studied. Seventy-three were alcoholic AP episodes; 40 patients had the ir first alcoholic AP episode. A standard personal interview was used to determine the alcohol consumption during 2 months and during 1 week before AP. The severity of AP was evaluated according to the Ranson c riteria, the serum C-reactive protein (CRP) concentration measured 24 to 48 hours after admission, the length of the hospital stay, the deve lopment of complications, and the mortality rate. Results. In the 40 p atients having their first alcoholic AP episode, the reported 2-month alcohol consumption correlated significantly with the number of positi ve Ranson criteria (correlation coefficient r = 0.44, p < 0.01), serum CRP concentration (r = 0.51, p < 0.001), and the length of the hospit al stay (r = 0.45, p < 0.01). Complications occurred in eight of 14 pa tients with 2-month alcohol consumption of more than 5000 gm as compar ed with one of 14 patients with consumption of less than 2000 gm (p < 0.05). In the same 40 patients the 1-week alcohol consumption correlat ed with the number of positive Ranson criteria (r = 0.40, p < 0.05) an d serum CRP concentration (r = 0.37, p < 0.05). Of the 12 patients who had consumed more than 1000 gm alcohol during the last week before ad mission, two died and complications developed in six (50%), as compare d with none (p < 0.05) and six (21%), respectively, of those who had c onsumed less than 1000 gm. No significant correlations were observed b etween the reported alcohol consumption and any of the severity parame ters in the 33 patients with recurrent episodes of alcoholic AP. Concl usions. The amount of alcohol consumed may be an important determinant of the severity of the first alcoholic AP episode but not of recurren t alcoholic AP.