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PWE-218 Risk factors predicting recurrent hospital admission acute pancreatitis
  1. A Ahmad,
  2. Y Khatun,
  3. S Dharmayan,
  4. M Barua,
  5. N Bostan,
  6. AA Ayantunde
  1. Surgery, Southend University Hospital, Westcliff-on-Sea, UK

Abstract

Introduction Acute pancreatitis is a relatively common condition and is associated with significant morbidity and mortality. Patients with acute pancreatitis do experience repeated hospital visits and admission due to recurrent symptoms. The aim of the study was to evaluate the factors that may predispose to recurrent pancreatitis requiring repeated hospital admission.

Method Demographic and clinical data of all patients admitted to our hospital with acute pancreatitis between January 2011 and December 2014 were retrospectively reviewed. We collected data relating to the severity using modified Glasgow scoring tool, length of hospital stay and outcomes including intensive care admission, presence of complications and acute pancreatitis specific mortality. Patients with recurrent hospital admission were identified and factors predicting repeat presentation were evaluated.

Results 569 patients with acute pancreatitis were admitted during the 4 year study period. There were 264 males and 305 females with the mean age of 60 (13–100) years. The aetiology factors included 290 gallstones, 91 alcohol induced, 142 idiopathic, 12 drug related, 9 hyperlipidaemia, 8 post ERCP, 8 pancreatic malignancy, 4 pancreatic divisum, 3 hypercalcaemia, 1 trauma and 1 autoimmune disease. 44.5% of the patients had at least one associated co-morbidity.

There were 449, 44 and 76 patients with mild, moderate and severe pancreatitis according to the modified Glasgow criteria. Majority of the patients (83%) were managed on the ward while 71 and 35 were admitted to the high dependency and intensive care units respectively. 105/569 (18.5%) patients developed complications and we recorded pancreatitis specific mortality rate of 4.7%.

35% (199/569) of the patients required repeated admissions ranging from 2–4 episodes. Factors such as the aetiology of pancreatitis and the presence of comorbidity are predictors of recurrent symptoms and repeated hospital admission. Patients with gallstone pancreatitis (p-value 0.002) and comorbidity (p-value 0.008) have more likelihood of representation. Patients older than 70 years were more likely to present with recurrent symptoms but the difference did not reach a statistically significant level (p-value (0.060). Factors such as gender, severity of pancreatitis and the presence of complications at the first presentation have no significant influence on recurrent presentation.

Conclusion Significant proportion of the patients with acute pancreatitis present with recurrent symptoms particularly those with gallstone induced with associated comorbidity. Early surgical and endoscopic treatment of the gallstones may prevent recurrent presentation.

Disclosure of interest None Declared.

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