title: Long-term outcome of severe acute pancreatitis.
abstract: OBJECTIVE
  This study was undertaken to evaluate the post-discharge outcome of severe acute pancreatitis (SAP) and to clarify the prognostic factors for poor outcome.
  
  
  METHODS
  In 45 patients, recurrence of acute pancreatitis (AP), transition to chronic pancreatitis (CP), and development of diabetes mellitus (DM) were evaluated. Relationships of the outcome with the findings on admission and the presence/absence of alcohol intake were analyzed.
  
  
  RESULTS
  The mean follow-up period was 56+/-6 months. Recurrence of AP was noted in 19% of the patients. The recurrence rate was higher in patients with necrotizing pancreatitis than in those without this feature. C-reactive protein and white blood cell (WBC) count were higher in patients with recurrence of AP. Transition to CP was noted in 22% of patients. The transition rate was higher in those with alcoholic SAP than in those with biliary SAP. In patients with transition to CP, the WBC count, hematocrit, Ranson score, and Japanese severity score were higher, and base excess (BE) was lower, compared with these features in patients without this transition. Development of DM was noted in 39% of patients. Blood glucose and BE were higher in patients who developed DM than in those who did not.
  
  
  CONCLUSIONS
  The degree of inflammation and pancreatic necrosis found on admission for SAP may be related to the recurrence of AP. Alcoholic SAP in which the disease is very severe may contribute to the transition to CP. Patients with impaired glucose tolerance readily develop DM after SAP.
authors.affiliation: Department of Gastroenterological Surgery, Kobe University Graduate School of Medical Sciences, Kobe, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Yasuda
authors.forename: Takashi
authors.initials: T
authors.lastname: Ueda
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Takeyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinzeki
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Sawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakajima
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kuroda
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D002097:C-Reactive Protein / Q000032:analysis; D003920:Diabetes Mellitus / Q000453:epidemiology; D006801:Humans; D009336:Necrosis; D010179:Pancreas / Q000473:pathology; D010195:Pancreatitis / Q000097:blood / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000453:epidemiology; D011379:Prognosis; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein