Clinical Research
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 28, 2008; 14(16): 2517-2521
Published online Apr 28, 2008. doi: 10.3748/wjg.14.2517
Severe acute pancreatitis in the elderly: Etiology and clinical characteristics
Ming-Jun Xin, Hong Chen, Bin Luo, Jia-Bang Sun
Ming-Jun Xin, Hong Chen, Bin Luo, Jia-Bang Sun, Department of General Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Author contributions: Sun JB and Xin MJ designed the research; Xin MJ and Chen H performed the research; Xin MJ and Luo B analyzed data and wrote the paper.
Correspondence to: Jia-Bang Sun, Department of General Surgery, Xuanwu Hospital, 45 Changchun Jie, Beijing 100053, China.
Telephone: +86-10-83198835
Fax: +86-10-83154745
Received: December 12, 2007
Revised: January 21, 2008
Published online: April 28, 2008

AIM: To investigate the etiology and clinical characteristics of severe acute pancreatitis (SAP) in elderly patients (≥ 60 years of age).

METHODS: We reviewed retrospectively all the SAP cases treated in Xuanwu Hospital in Beijing between 2000 and 2007.

RESULTS: In 169 patients with SAP, 94 were elderly and 16 died. Biliary and idiopathic etiologies were the first two causes that accounted for over 90% of SAP in the elderly. Biliary, hyperlipemic and alcoholic etiologies were the first three causes in the young. The proportion of co-morbidity of cholelithiasis, biliary infection, hypertension and coronary heart disease in the aged was significantly higher than that in their young partners. The scores of APACHE II and Ranson were also significantly higher in the elderly except the CT score. Organ failures were more common in the elderly, but the local pancreatic complications were not different between the two groups. Mortality of the aged was correlated with the severity of SAP, multiple co-morbidity and incidence of multiple organ dysfunction syndrome (MODS). MODS was the main cause of death.

CONCLUSION: The etiology of SAP in the elderly is quite different from that in the young. Biliary and unknown factors are main causes in the aged. The elderly are subject to major organ failures but there is no difference in the occurrence of local pancreatic complications between the elderly and the young. It is crucial to monitor and improve the functions of major organs so as to prevent MODS in the aged with SAP.

Keywords: Severe acute pancreatitis, Elderly, Etiology, Mortality, Complication