Introduction The management of acute idiopathic pancreatitis (AIP) remains a challenge. There are no strong recommendations available to help with its management. Its impact on patient outcome is still not clear. Our aim was to compare the outcomes between patients presenting with AIP to those with acute non-idiopathic pancreatitis (NIP).
Method A retrospective data collection was performed for all patients presenting with acute pancreatitis in a district general hospital during a 4-year period between January 2011 and December 2014. Data was collected using electronic patient records. Patient demographics, aetiology of pancreatitis and outcomes for all patients were analysed. Outcomes were defined as mortality due to acute pancreatitis, ITU admission, pancreatic necrosis and multi organ failure.
Results During the 4-year study period 569 patients were diagnosed with acute pancreatitis. Out of all the patients 142/569 (25%) were diagnosed as having AIP. There was no significant difference in mean age in the two groups (AIP 59yrs; NIP 60yrs). There was a significantly higher incidence of female patients diagnosed with AIP (63%) compared to the NIP group (51%; P = 0.012). Twenty-one out of 142 patients with AIP (15%) had overall poor outcomes compared to 30/427 (7%) patients in the NIP group (OR 2.29; 95% CI 1.27 – 4.16; P = 0.006). AIP has significantly poor outcome compared with NIP for pancreatitis specific mortality (OR 3.79; CI 1.70 – 8.38; P = 0.0001), ITU admission (OR 2.73; CI 1.36 – 5.46; P = 0.003) and multi organ failure (OR 2.97; CI 1.36 – 6.49; P = 0.004).
Conclusion Patients with IP have a significantly higher morbidity and pancreatitis specific mortality compared with NIP. This reflects our lack of understanding about the mechanisms that trigger pancreatitis in this group of patients. In addition, a more vigorous management pathway needs to be established to optimise the investigations and further management of this high-risk group of patients.
Disclosure of interest None Declared.