Acute pancreatitis in the elderly - Can we perform better?

Somasekar, K; Foulkes, Rhiannon; Morris-Stiff, G.; Hassn, Ahmed

doi:10.1016/j.surge.2010.11.001

Cited by 28 publications

(23 citation statements)

References 18 publications

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“…With the clinical presentation of aging AP patients, more severe manifestations was found in the oldest group as compared to the older group in our study. The phenomenon has also been evidenced by previous research that increasing age was closely related to a more severe clinical course of AP [15][16][17][18]27]. The underlying mechanism of the above condition is still debate.…”

Section: Discussionmentioning

confidence: 65%

“…While previous study found that the death rate reached up to 20% in older patients aged over 55 years old [34,41]. Another literature proposed the clinical course of AP patients aged ≥ 80 years was evidenced the death rate up to 25% [16,41]. In addition, a lower death rate (7.1%) was evidenced in recent study in older patients over 65 years old [13].…”

Section: Discussionmentioning

confidence: 88%

“…Abdominal symptom of abdominal pain (61.3% vs 46.3%, P=0.013) was less in oldest group, while diarrhea(18.3% vs 30.0%, P=0.018), jaundice(8.9% vs 17.5%, P=0.021), dyspnea(11.5% vs 26.3%, P=0.001) were more obvious in older group than oldest group. A higher death rate (8.9% vs 16…”

Section: Resultsmentioning

confidence: 98%

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The clinical traits of acute pancreatitis in aging patients: a retrospective analysis of 473 cases

Lü¹,

Yu²,

Xie³

2020

Preprint

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Background The incidence of acute pancreatitis in aging patients has increasing in recent years. Controversial results about clinical outcomes of acute pancreatitis in aging patients were reported in different literature. The aim of our study was to compare the clinical outcomes of AP in aging patients between 60-79 years old and over 80 years old. Methods 80 patients aged ≥ 80 years old(oldest group) were compared to 393 patients aged 60 to 79 years old(older group). The clinical course, biochemical, radiological data were enrolled. The primary endpoint was to compare the death rate, intensive care unit admission rate and in-hospital length of stay(LOS). The secondary endpoint was operative treatment and the complications of AP. Results Abdominal symptom of abdominal pain (61.3% vs 46.3%, P=0.013) was less in oldest group, while diarrhea(18.3% vs 30.0%, P=0.018), jaundice(8.9% vs 17.5%, P=0.021), dyspnea(11.5% vs 26.3%, P=0.001) were more obvious in older group than oldest group. A higher death rate (8.9% vs 16.3%, P = 0.003) and longer hospital length of stay (11.51±10.19 vs 15.26±11.04, P = 0.001) were found in aging patients aged ≥80 years old. Mean BMI was lower in oldest group compared to older group(22.36±2.89 vs 21.07±3.18, P = 0.001). Multivariate analysis identified aged over 80 years(OR 3.299, 95%CI 1.316-8.269, P=0.011) and organ failure(P<0.05) as independent risk factors of mortality. More severe of AP(OR 11.722, 95%CI 4.780-28.764, P=0.001), abdominal pain(OR 1.906, 95%CI 1.052-3.453, P=0.033) and organ failure(P<0.05) were recognized as influencing intensive care unit rate. Aging patients aged over 80 years old(OR 0.149, 95%CI 2.027-6.268, P=0.001), more severe of AP(OR 0.218, 95%CI 1.567-4.322, P=0.001), female(OR 0.093, 95%CI 0.336-3.542, P=0.018), Jaundice(OR 0.080, 95%CI 0.146-5.324, P=0.038), operative treatment(P<0.05) and organ failure(P<0.05) were the risk factors for LOS.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 88%

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The clinical traits of acute pancreatitis in aging patients: a retrospective analysis of 473 cases

Lü¹,

Yu²,

Xie³

2020

Preprint

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“… 38 The discrepancy in the use of cholecystectomy for ageing patients reflects the trend toward avoiding operative treatment in cases not suitable for operation. 16 In reality, the approach conforms to the situation in China in which ageing patients often refuse to undergo surgical procedures in hospitals that can alleviate the disease. They fear a poor prognosis and high rates of infection and mortality.…”

Section: Discussionmentioning

confidence: 99%

<p>The Clinical Characteristics of Acute Pancreatitis in Gerontal Patients: A Retrospective Study</p>

Yu¹,

Li²,

Li³

et al. 2020

CIA

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Background The incidence of acute pancreatitis (AP) in ageing patients has increased in recent years, and results regarding the clinical outcomes of these patients are controversial. The aim of this study was to compare the clinical outcomes of AP in ageing patients over 60 years old. Methods Eighty patients aged ≥80 years (oldest group) were compared to 393 patients aged 60 to 79 years (older group). The clinical course and biochemical and radiological data were evaluated. The primary endpoints were mortality rate, intensive care unit (ICU) admission rate and in-hospital length of stay (LOS). The secondary endpoints were the incidence of operative treatment and complications of AP. Results Abdominal pain (61.3% vs 46.3%, P=0.013) was less common in the oldest group. Jaundice (17.5% vs 8.9%, P=0.021) and dyspnoea (26.3% vs 11.5%, P=0.001) were more obvious in the oldest group than in the older group. The mean BMI was lower in the oldest group than in the older group (21.07±3.18 vs 22.36±2.89, P = 0.001). Age over 80 years (P=0.011) and organ failure (P<0.05) were independent risk factors for mortality. More severe AP (P=0.001), abdominal pain (P=0.033) and organ failure (P<0.05) were associated with the ICU admission rate. Age over 80 years (P=0.001), more severe AP (P=0.001), female sex (P=0.018), jaundice (P=0.038), operative treatment (P<0.05) and organ failure (P<0.05) were risk factors for increased LOS. Conclusion The oldest group had a higher death rate and longer LOS than the older group. More attention should be given to the clinical symptoms of this frail population. We propose that more comprehensive and goal-directed attendant diagnostic procedures should be performed to detect the disease early and to improve the outcomes of ageing patients.

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“…Однако в австралийском когортном ис следовании сообщается, что лекарственный пан креатит в 3,4 раза чаще встречался у женщин, чем у мужчин [9]. Кроме того, имеются данные литерату ры о том, что поражения поджелудочной железы, связанные с употреблением ЛС, чаще развиваются у пожилых [10] и у детей с болезнью Крона или забо леваниями системы крови [11].…”

Section: примеры побочного действия лс на поджелудочную железуunclassified

The adverse effects exerted by medication therapy on the pancreatic gland

Гуревич¹,

Belousov²

2014

Dok. gastroenterol.

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Acute pancreatitis in the elderly - Can we perform better?

Cited by 28 publications

References 18 publications

The clinical traits of acute pancreatitis in aging patients: a retrospective analysis of 473 cases

The clinical traits of acute pancreatitis in aging patients: a retrospective analysis of 473 cases

<p>The Clinical Characteristics of Acute Pancreatitis in Gerontal Patients: A Retrospective Study</p>

The adverse effects exerted by medication therapy on the pancreatic gland

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