title: Acute pancreatitis in five European countries: etiology and mortality.
abstract: BACKGROUND
  In recent years, many advances have been made in the diagnosis and treatment of acute pancreatitis that have lead to a significant reduction in both morbidity and mortality; however, knowledge of the etiology and of the relation between etiology and mortality is far from complete.
  
  
  OBJECTIVE
  To obtain a more comprehensive view of the etiology and mortality of acute pancreatitis in Europe than has been given by previous single-center studies.
  
  
  METHODS
  The study comprised 1,068 patients in five European countries who were admitted to hospitals for acute pancreatitis from January 1990 to December 1994. Data for each patient were collected on a standardized form.
  
  
  RESULTS
  Of the 1,068 patients (692 men, 376 women; mean age, 52.8 years; range, 10-95 years), 589 had edematous pancreatitis, and 479 the necrotic form. Cholelithiasis (37.1%) and alcohol (41.0%) were the most frequent etiologic factors. In Germany, cholelithiasis and alcohol occurred with similar frequency (34.9 and 37.9%, respectively); in Hungary, alcohol predominates over cholelithiasis (60.7 vs. 24.0%); in France, a small predominance of alcohol was seen (38.5 vs. 24.6%); and in Greece and Italy, there was a clear predominance of cholelithiasis over alcohol (71.4 vs. 6.0% and 60.3 vs. 13.2%, respectively). The differences in the frequency of cholelithiasis and alcohol between Greece and Italy and the other countries were statistically significant (p < 0.01). Eighty-three patients (7.8%) died of acute pancreatitis; 77 (16.1%) had necrotic disease and 6 (1.0%) edematous. There was no statistically significant difference in mortality among the etiologic groups, and no relation was found between mortality and age.
  
  
  CONCLUSIONS
  Both cholelithiasis and alcohol were main etiologic factors in the more northern countries studied, whereas cholelithiasis alone predominated in the more southern ones. Mortality was high for necrotic pancreatitis; it was similar among the various etiologic groups, and there was no relationship between mortality and age.
authors.affiliation: Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy. tomasset@med.unibo.it
authors.forename: Lucio
authors.initials: L
authors.lastname: Gullo
authors.forename: Marina
authors.initials: M
authors.lastname: Migliori
authors.forename: Attila
authors.initials: A
authors.lastname: Oláh
authors.forename: Gyula
authors.initials: G
authors.lastname: Farkas
authors.forename: Philippe
authors.initials: P
authors.lastname: Levy
authors.forename: Constantine
authors.initials: C
authors.lastname: Arvanitakis
authors.forename: Paul
authors.initials: P
authors.lastname: Lankisch
authors.forename: Hans
authors.initials: H
authors.lastname: Beger
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002769:Cholelithiasis / Q000150:complications; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006115:Greece / Q000453:epidemiology; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000209:etiology* / Q000401:mortality*; D019512:Pancreatitis, Alcoholic / Q000401:mortality