Evaluation of the clinical course and prognostic indices of acute pancreatitis in elderly patients : a prospective study

Background and aim: Acute pancreatitis (AP) is a life- threatening condition across all age groups. In this study, it was aimed to investigate the severity of the disease and associated mortality in the geriatric population.

Methodology: This single-center, prospective study elderly (≥65 years of age) and younger (18-65 years of age) total 147 patients with AP are enrolled To diagnose and asses the severity of AP Atlanta classification was used. Baseline and 12-months follow-up data included Ranson, Imrie, BISAP, APACHE-II, SOFA, Modified Marshall, Balthazar, and Computed Tomography Severity Index (CTSI) as prognostic tools.

Results: 6 (15%) patiens in elderly and 5 (6,7%) patients in non elderly group had modarete-severe AP . Patients were followed up 1 year and during this time no systemic complications were seen , 8 (20%) patients in elderly group and 10 (13,6%) patients in younger group had local complications. 1 patients in elderly and 2 patients in non elderly group had acute necrotic collection whereas 1 patient developed walled of necrosis in non elderly group. The elderly patients with any of the following index characteristics would not be expected to have a mild disease course: Imrie score ≥ 3, BISAP score ≥ 3, APACHE-II ≥ 11, CRP ≥ 195 mg/dl

Conclusions: AP caused a prolonged hospitalization in the elderly compared to younger patients but its severity and clinical outcomes were not different in the two groups.

Keywords: Acute pancreatitis, APACHE, Blood urea nitrogen, C-reactive protein, elderly patients, prognosis.