title: Comparison of clinical course and outcome of acute pancreatitis according to the two main etiologies: alcohol and gallstone.
abstract: BACKGROUND
  Studies concerning clinical course and outcome of acute pancreatitis (AP) according to etiologies were rare, especially after year 2000. This study was designed to investigate the difference between the clinical course of alcoholic and biliary AP.
  
  
  METHODS
  Of the 153 patients diagnosed as AP with a first attack between January 2011 and January 2013, extensive clinical data of 50 patients with AP caused by alcohol and 76 patients with AP caused by gallstone were analyzed retrospectively. We compared the severity of AP defined by revised Atlanta classification in 2012, local complications, severity scores, and computed tomography severity index (CTSI) between alcoholic and biliary AP. We also evaluated the length of hospital stay, duration of NPO, and in-hospital mortality in each group.
  
  
  RESULTS
  Hemoglobin, hematocrit, and serum C-reactive protein level measured after admission for 24 h were significantly higher in the alcohol group than in the biliary group. Incidence of pseudocyst formation was significantly higher in the alcohol group than in the biliary group (20.0 % vs. 6.6 %, P = 0.023). Among prognostic scoring systems, only CTSI showed significant difference (P < 0.001) with a mean score of 3.0 ± 0.9 in the alcohol group and 1.7 ± 1.2 in the biliary group. Severe AP with organ failure persisting beyond 48 h was observed in 12 patients (24.0 %) in the alcohol group and one patient (1.3 %) in the biliary group (P < 0.001). There were 4 mortalities in the alcohol group only (P = 0.012).
  
  
  CONCLUSIONS
  More severe forms of AP and local complication, such as pseudocyst formation, are associated with alcoholic AP compared with biliary AP.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1, Daemyung 5-dong, Nam-gu, Daegu, 705-717, Republic of Korea. ygowgo96@hanmail.net.
authors.forename: Joon Hyun
authors.initials: JH
authors.lastname: Cho
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1, Daemyung 5-dong, Nam-gu, Daegu, 705-717, Republic of Korea. tnkim@yu.ac.kr.
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1, Daemyung 5-dong, Nam-gu, Daegu, 705-717, Republic of Korea. jeje0620@naver.com.
authors.forename: Sung Bum
authors.initials: SB
authors.lastname: Kim
mesh_terms: D018806:APACHE; D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D042882:Gallstones / Q000150:complications*; D006400:Hematocrit; D006454:Hemoglobins; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000453:epidemiology / Q000209:etiology; D010195:Pancreatitis / Q000097:blood / Q000209:etiology / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
chemical_list: D006454:Hemoglobins; D002097:C-Reactive Protein