Long-term follow-up after the first episode of acute alcoholic pancreatitis: Time course and risk factors for recurrence

Background: Owing to the current lack of long-term follow-up data on the re currence of alcohol-induced acute pancreatitis (AP), we studied the pattern of recurrence and determined the characteristics of the disease to predict the recurrence. Methods: Between 1972 and 1991, 2678 AP episodes were dete cted; 1555 were induced by alcohol, and 591 of them were the first episode. During the first alcohol-induced AP 29 patients died and were excluded fro m further analysis. Of the 562 included, 503 were men, and 59 women. Admiss ion serum tests, severity index, development of complications, intensive ca re unit and hospital stay, and need for surgery were assessed. Case records were studied. The national database was used to detect admissions to other hospitals. Results: Overall, 260 (46%) developed recurrent disease. Of the first relapses, 80% developed during 4 years. The recurrence rate has net changed with time. Age less than 45 years increased the risk (odds ratio (O R) = 2.42; 95% confidence interval (CI), 1.30-4.50). The risk factors of th e first alcohol-induced AP associated with the development of multi-recurri ng pancreatitis are age <45 years (OR, 2.42; 95% CI, 1.59-13.0), 0-2 positi ve Glasgow criteria (OR, 2.45; 95% CI, 1.16-5.19), and arterial oxygen tens ion >60 mmHg (OR, 9.90; 95% CI, 1.32-74.3). Conclusions: Fewer than half of the patients develop recurrent alcohol-induced AP. Younger patients are at the highest risk of recurrence. Those whose first alcohol-induced pancreat itis episode was not severe are at a higher risk of developing multi-recurr ing pancreatitis.