title: Progression from acute to chronic pancreatitis: prognostic factors, mortality, and natural course.
abstract: OBJECTIVE
  Knowledge of the natural course of acute pancreatitis (AP) and risk of progression to chronic pancreatitis (CP) is limited. The aims were to describe: (1) the incidence of progression from AP to CP, (2) prognostic factors for progression, and (3) the natural course and mortality of progressive AP.
  
  
  METHODS
  During 1977 to 1982, patients admitted to hospitals in Copenhagen with a diagnosis of AP or CP were included in a prospective cohort and followed up by the Danish registries in 2008. The subcohort analyses comprised 352 AP patients.
  
  
  RESULTS
  Progressive AP was found in 85 patients (24.1%) during follow-up; 48.2% developed from alcoholic AP, 47.0% from idiopathic AP, and 4.8% from other causes. The mortality rate for patients with progressive AP was 2.7 times higher than in patients with nonprogressive acute pancreatitis, and 5.3 to 6.5 times higher than in the background population. In Cox regression analyses corrected for age, only smoking was of significance for the progression from AP to CP.
  
  
  CONCLUSIONS
  Acute pancreatitis can progress to CP, not only from alcoholic but also from nonalcoholic AP. Smoking was the strongest risk factor associated with progression. The mortality rate for these patients was 5 to 6 times the mortality rate in the population.
authors.affiliation: Department of Gastroenterology, Hvidovre Hospital, Denmark. mille@dadlnet.dk
authors.forename: Camilla
authors.initials: C
authors.lastname: Nøjgaard
authors.forename: Ulrik
authors.initials: U
authors.lastname: Becker
authors.forename: Peter
authors.initials: P
authors.lastname: Matzen
authors.forename: Jens Rikardt
authors.initials: JR
authors.lastname: Andersen
authors.forename: Claus
authors.initials: C
authors.lastname: Holst
authors.forename: Flemming
authors.initials: F
authors.lastname: Bendtsen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010195:Pancreatitis / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D019512:Pancreatitis, Alcoholic / Q000150:complications / Q000401:mortality; D050500:Pancreatitis, Chronic / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000706:statistics & numerical data; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016019:Survival Analysis; D015996:Survival Rate