Acute pancreatitis: A 7 year retrospective cohort study of the epidemiology, aetiology and outcome from a tertiary hospital in Jamaica

Abstract

BackgroundAcute pancreatitis (AP) is a significant cause of acute abdominal pain, morbidity and hospitalisation. There was previously a dearth of studies exploring the incidence, risk factors and outcome of AP in the Caribbean region.Materials and methodsAll patients with a diagnosis of AP admitted to the University Hospital of the West Indies (UHWI) between 2006 and 2012 were reviewed. The epidemiological profile, risk factors, clinical presentation and outcomes of patients with AP were retrospectively studied.ResultsThere were 70 females and 21 males with a median age of 44 years (range 2–86). The median age of males was significantly higher than that of females (p = 0.041). The incidence of AP was 74 per 100,000 admissions per year. Vomiting and abdominal tenderness were noted in the majority of patients. The most common aetiology was biliary disease (71.4%), idiopathic (12%), post-ERCP (6.6%) and alcohol (5.5%). Alcoholic pancreatitis was only seen in males whereas idiopathic and post-ERCP pancreatitis only occurred in females. The mean duration of hospitalisation was 9.51 ± 8.28 days. Disease severity was mild in 61.1%, moderately severe in 26.7%, and severe in 12.2% of patients. Factors associated with more severe disease included overweight/obesity, idiopathic aetiology and post-ERCP status. The case fatality rate was 2%.ConclusionThe incidence of AP was 74/100,000 hospital admissions annually. There was an unusual female preponderance, with biliary pancreatitis being the most common type occurring at an equal frequency among males and females. Only 12.2% of the total cases seen were severe. The case fatality rate was 2%. Local health policy should target timely interventions for biliary pancreatitis and should also address the local factors affecting disease severity.

Etiology, clinical profile and outcome of acute pancreatitis in a tertiary care teaching hospital in rural South India: a ten year retrospective study

“…Similar results was obtained in the study done by Reid in Jamaica (71.8%). 3 Acute fluid collection was present in 33.715% of cases and this is in concordance with the results of Sameer et al in a study at bhopal where acute fluid collection was found in 34% of patients and Banday et al in a study conducted at Jammu where it was found to be 36%. 12,13 Respiratory system involvement was the most common systemic complication (16.5%).…”

“…Abdominal pain was present in all cases which were in concordance with the study done by Reid et al where abdominal pain was present in 96.7% cases. 3 Nausea and vomiting was present in 70.183% cases. Similar results was obtained in the study done by Reid in Jamaica (71.8%).…”

“…This was in concordance with the studies done by Reid and Raghuvanshi. 3,12 Disease severity was mild in 82.1% of cases and severe in 4.4% of cases. Similar results were obtained in the study done in North India by Ahlawat et al where 82% cases were classified as mild.…”

“…2 The etiological spectrum of acute pancreatitis includes the most common gallstones, alcohol, trauma, idiopathic, drug induced, metabolic disorders (hyperlipidemia, hypercalcemia), post-ERCP, congenital anomalies such as pancreas divisum to the rarest scorpion sting. 3 The management strategies vary from medical supportive measures to surgical management in complicated cases when indicated. The etiological factors are greatly affected by geography, cultural and socioeconomic background.…”

“…For example, alcoholic pancreatitis and tropical pancreatitis which are more endemic in certain areas. 3 There are several predictors of severity of Acute Pancreatitis which include clinical predictors (age, sex, alcoholic pancreatitis, obesity and organ failure), laboratory predictors (hemoconcentration, CRP, serum creatinine, BUN etc. ), Radiological predictors (CT scan, MRI, MRCP).…”