Severe acute pancreatitis in the elderly: etiology and clinical characteristics.
OBJECTIVE
To investigate the etiology and clinical characteristics of severe acute pancreatitis (SAP) in elderly patients (> or = 60 years of age).


METHODS
We reviewed retrospectively all the SAP cases treated in Xuanwu Hospital in Beijing between 2000 and 2007.


RESULTS
In 169 patients with SAP, 94 were elderly and 16 died. Biliary and idiopathic etiologies were the first two causes that accounted for over 90% of SAP in the elderly. Biliary, hyperlipemic and alcoholic etiologies were the first three causes in the young. The proportion of co-morbidity of cholelithiasis, biliary infection, hypertension and coronary heart disease in the aged was significantly higher than that in their young partners. The scores of APACHE II and Ranson were also significantly higher in the elderly except the CT score. Organ failures were more common in the elderly, but the local pancreatic complications were not different between the two groups. Mortality of the aged was correlated with the severity of SAP, multiple co-morbidity and incidence of multiple organ dysfunction syndrome (MODS). MODS was the main cause of death.


CONCLUSIONS
The etiology of SAP in the elderly is quite different from that in the young. Biliary and unknown factors are main causes in the aged. The elderly are subject to major organ failures but there is no difference in the occurrence of local pancreatic complications between the elderly and the young. It is crucial to monitor and improve the functions of major organs so as to prevent MODS in the aged with SAP.
Xin
Ming-Jun
MJ
Department of General Surgery, Xuanwu Hospital, 45 Changchun Jie, Beijing 100053, China.
Chen
Hong
H
Luo
Bin
B
Sun
Jia-Bang
JB
D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D000681:Amylases / Q000097:blood; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D019283:Pancreatitis, Acute Necrotizing / Q000209:etiology / Q000401:mortality / Q000503:physiopathology*; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors
D000681:Amylases