Influence of advanced age and related comorbidity on the course and outcome of acute pancreatitis

Background and Aims. Aging process and comorbidity have been held to influe nce the course and outcome of acute pancreatitis in elderly patients. The a im of the present study was to investigate this issue in a large series of patients greater than or equal to 70 years of age suffering from acute panc reatitis. Patients and Methods. A retrospectively study was carried out on 439 patien ts with a first episode of AP. The patients were divided into into age grou ps: less than or equal to 69 years (n = 340) and greater than or equal to 7 0 years (n = 99). Differences in general characteristics, aetiological fact ors, blood tests and laboratory data, severity of the disease and outcome w ere evaluated. The presence of intercurrent diseases was also investigated in the two age groups. Results. No significant difference was observed in the distribution of the various aetiological factors in the two age groups considered. The percenta ge of patients with necrotizing forms of AP, Ranson prognostic score for se verity, local and systemic complications, the number of patients requiring surgical intervention or endoscopic sphincterotomy, us well as length of ho spital stay were similar in the two groups. Considering the patients suffer ing from necrotizing acute pancreatitis, a significant increase (p=0.01) in mortality was observed in greater than or equal to 70-year-old patients (2 5.8 vs 7.8%). Associated diseases were significantly more frequent in advan ced age (63.6 vs 41.4%; p=0.0004), but morbidity did not correlate with the presence of pancreatic necrosis, the need for surgery or endoscopic sphinc terotomy, and with mortality. Conclusions. The results of this study suggest that advanced age and relate d comorbidity have only a limited influence on the course and outcome of ac ute pancreatitis.