title: An assessment of the severity of interstitial pancreatitis.
abstract: OBJECTIVE
  There is limited information on the incidence of and factors associated with severe disease among patients with interstitial pancreatitis (IP). We evaluated a large cohort of patients with IP and compared data with those from patients with extrapancreatic necrosis (EXPN).
  
  
  METHODS
  We evaluated 149 consecutive patients with IP admitted over a 2.5-year period. Transferred patients were excluded. We collected data on age, Charlson comorbidity score (CCI), measures of severity on admission or within 24 hours (Acute Physiology and Chronic Health Evaluation II, bedside index for severity of acute pancreatitis scores), persistent (>48 h) systemic inflammatory response syndrome, persistent organ failure, need for intensive care unit, length of hospital stay (in days), and mortality. We also analyzed levels of severity among those with IP and EXPN. Statistical analysis was performed using SAS version 9.1 (Cary, NC).
  
  
  RESULTS
  Among the patients with IP, the median CCI score was 1, the median Acute Physiology and Chronic Health Evaluation II score was 7, and the median bedside index for severity of acute pancreatitis score was 1. In addition, the median length of hospital stay was only 4 days; only 1% had persistent organ failure and only 1% to 2% required intervention. The mortality rate of IP was 3%; it was associated significantly with comorbidity (the median CCI scores of nonsurvivors and survivors was 4 and 1, respectively, P = .003). Patients with EXPN had greater levels of disease severity, compared with patients with IP.
  
  
  CONCLUSIONS
  IP is severe in only 1% to 3% of patients; mortality of IP is associated strongly with comorbidity. EXPN is more frequently severe than IP; EXPN must be distinguished from IP in clinical studies.
authors: Division of Gastroenterology, Center for Pancreatic Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. vsingh1@jhmi.edu
authors: Vikesh K
authors: VK
authors: Singh
authors: Thomas L
authors: TL
authors: Bollen
authors: Bechien U
authors: BU
authors: Wu
authors: Kathryn
authors: K
authors: Repas
authors: Rie
authors: R
authors: Maurer
authors: Song
authors: S
authors: Yu
authors: Koenraad J
authors: KJ
authors: Mortele
authors: Darwin L
authors: DL
authors: Conwell
authors: Peter A
authors: PA
authors: Banks
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D012720:Severity of Illness Index; D016019:Survival Analysis