Copenhagen Pancreatitis Study

Abstract

During the past 2 decades an increasing number of patients with pancreatitis have been admitted to the Copenhagen hospitals. For this reason all departments receiving such patients from the city of Copenhagen initiated the Copenhagen Pancreatitis Study (CPS), to provide a prospective recording of all pancreatitis patients from this geographical area and to conduct yearly follow-up studies of the patients. The aims of the CPS were, first, to establish data on the incidence, prevalence, and clinical characteristics of pancreatitis, and, second, to evaluate the accuracy of diagnostic tests applied and to provide data on the natural history and the prognosis under current therapy. The present study is an interim report on 343 patients from the initial 1 1/2 years of the CPS. Pancreatitis patients are listed in four diagnostic groups: I. Possible acute pancreatitis; II. Acute pancreatitis; III. Possible chronic pancreatitis; IV. Chronic pancreatitis. The incidence rates per year per 100,000 citizens aged 20 years or more (population aged 20 years or more: 417,000) were as follows: total, 36.3; I, 6.2; II, 21.9; III, 4.2; IV, 4.0. The prevalence for the chronic types on 31 August 1979 per 100,000 citizens aged 20 years or more was as follows: total, 27.4; III, 14.4; IV, 13.0. Gallstones were found in 1/3 of the acute and 1/10 of the chronic cases. Alcohol consumption was more than 50g/day in nearly half of the patients. Acute pancreatitis was dominated by a high leukocyte count, hyperbilirubinaemia, raised aminotransferases and blood glucose levels, and low albumin and calcium levels in serum. In chronic pancreatitis 1/3 had steatorrhoea; 1/6 regularly used morphine, and 1/4 had impaired liver function. It is concluded that the incidence rates of acute and chronic pancreatitis in Copenhagen seem to be higher than those reported elsewhere; however, differences in diagnostic criteria may play a role. The clinical and laboratory findings are in agreement with other studies.

Key-words:

• Abdomen, acute condition
• alcohol drinking
• amylase
• blood sugar
• calcium
• cholelithiasis
• epidemiology
• liver disease
• morphine
• pancreatic disease
• pancreatitis
• prospective studies

Notes

*Members of the Copenhagen Pancreatitis Study Group are J. R. Andersen, O. Backer, J. T. Balsløv, O. Bonnevie, F. Burcharth, I. Christoffersen, P. Christoffersen, B. Clausen, D. Ehlers, K. Fischermann, H.-J. Frederiksen, R. Friedberg, B. Hamilton, F. Hardt, J. Hegnhøj, S. Jarnum, H.-E. Jensen, P. Jess, T. Justesen, J. Kjárgaard, P. Klarskov, E. Krag, P. Madsen, E. Magid, A. Malchow-Møller, H. Marcussen, P. Matzen, B. Nørgaard, O. Pedersen-Bjergaard, D. Raahave, A. Schmidt, B. Stigsby, D. Teilum, A. Uhrenholdt, B. Villumsen, K. Winkler. Our knowledge concerning the epidemiology of pancreatitis is based on a few retrospective studies (3, 9, 16, 19), which, like the large studies on pancreatitis, come from centres with a special interest in pancreatic diseases. Such study groups might be biased by severe and complicated cases. In the only prospective study available on the natural history of pancreatitis, 100 patients were studied for 1 year (12).