Elderly persons with acute pancreatitis – specifics of the clinical course of the disease

Figures & data

Table 1 Characteristics of patients with AP, as stratified by age

Variables	Patients aged <65 years	Patients aged 65–79 years	P-value	OR (95% CI)	Patients aged ≥80 years	P-value	OR (95% CI)
	Group I, n (%)	Group II, n (%)	Group II vs Group I		Group III, n (%)	Group III vs Group I
Number	650 (67.50)	196 (20.35)	–	–	117 (12.15)	–	–
Age, years	43.94 (±12.11)	72.36 (±4.59)	–	–	84.72 (±3.94)	0.00	–
Women/men	181/469 (27.85/72.15)	106/90 (54.08/45.92)	0.00	0.33 (0.24–0.45)	81/36 (69.23/30.77)	0.00	0.17 (0.11–0.26)
Causes of the disease
Alcohol abuse	235 (36.15)	8 (4.08)	0.00	0.07 (0.043–0.15)	0	0.00	–
Biliary	146 (22.46)	106 (54.08)	0.00	4.07 (2.91–5.69)	68 (58.12)	0.00	4.82 (3.20–7.28)
Others	23 (3.54)	6 (3.06)	0.75	0.86 (0.34–2.14)	9 (7.69)	0.04	2.27 (1.02–5.03)
Idiopathic	246 (37.85)	76 (38.78)	0.81	0.96 (0.69–1.33)	40 (34.19)	0.44	1.17 (0.78–1.78)
Mild AP	505 (77.69)	155 (79.08)	0.68	1.08 (0.73–1.60)	90 (76.92)	0.84	0.95 (0.59–1.52)
Moderate AP	104 (16)	26 (13.27)	0.35	0.80 (0.50–1.28)	10 (8.55)	0.04	0.49 (0.25–0.98)
Severe AP	41 (6.31)	15 (7.69)	0.50	1.24 (0.67–2.29)	17 (14.53)	0.00	2.55 (1.37–4.54)
Death	15 (2.31)	9 (4.59)	0.10	2.04 (0.88–4.73)	14 (11.97)	0.00	5.74 (2.69–12.25)
Most frequent concomitant diseases
Hypertension	117 (18.00)	96 (48.98)	0.00	4.41 (3.12–6.23)	64 (54.70)	0.00	5.55 (3.66–8.41)
Coronary heart disease	23 (3.54)	54 (27.55)	0.00	10.35 (6.15–17.42)	44 (37.61)	0.00	16.40 (9.37–28.71)
Diabetes mellitus type 2	28 (4.31)	26 (13.27)	0.00	3.52 (2.00–6.20)	17 (14.53)	0.00	3.92 (2.06–7.45)
Diabetes mellitus type 1	5 (0.77)	8 (4.08)	0.00	5.48 (1.77–16.95)	3 (2.56)	0.10	3.39 (0.80–14.38)
Circulatory failure	5 (0.77)	17 (8.67)	0.00	15.31 (5.09–46.09)	21 (17.95)	0.00	35.27 (11.85–104.97)
Atrial fibrillation	5 (0.77)	17 (8.67)	0.00	12.23 (4.45–33.61)	13 (11.11)	0.00	16.10 (5.62–46.10)
Degenerative joint disease	7 (1.08)	13 (6.63)	0.00	6.51 (2.56–16.57)	4 (3.42)	0.06	3.24 (0.93–11.27)
COPD	11 (1.69)	14 (7.14)	0.00	4.62 (1.99–10.00)	9 (7.69)	0.00	4.83 (1.96–11.94)
Chronic renal failure	2 (0.31)	7 (3.57)	0.00	11.98 (2.47–58.16)	5 (4.27)	0.00	14.44 (2.77–75.35)

Note: Statistically significant differences were indicated in bold type.

Abbreviation: AP, acute pancreatitis.

Table 2 Results of bivariate and multivariate analyses, in consideration of a clinical course of AP

	Bivariate analysis		Multivariate analysis
	OR (95% CI)	P-value	OR (95% CI)	P-value
Moderate AP vs mild AP
Age, years	0.99 (0.98–1.01)	0.12	0.99 (0.98–1.01)	0.37
Gender, M/F	1.27 (1.04–1.54)	0.02	1.19 (0.95–1.50)	0.14
Causes of the disease
Alcohol abuse	1.24 (1.02–1.51)	0.03	1.24 (0.96–1.60)	0.09
Biliary	0.83 (0.67–1.01)	0.07	1.08 (0.85–1.39)	0.52
Others	–	–	–	–
Idiopathic	1.43 (1.16–1.76)	0.001	1.42 (1.15–1.76)	0.00
Most frequent concomitant diseases
Hypertension	0.98 (0.80–1.20)	0.84	1.07 (0.83–1.37)	0.62
Coronary heart disease	1.00 (0.76–1.3)	0.10	1.07 (0.75–1.52)	0.70
Diabetes mellitus type 2	0.75 (0.49–1.15)	0.19	0.96 (0.63–1.46)	0.85
Diabetes mellitus type 1	1.04 (0.48–2.23)	0.92	1.21 (0.56–2.64)	0.63
Circulatory failure	074 (0.41–1.35)	0.33	0.99 (0.55–1.81)	0.99
Atrial fibrillation	0.77 (0.42–1.40)	0.39	0.96 (0.50–1.83)	0.90
Degenerative joint disease	0.95 (0.51–1.76)	0.87	1.20 (0.61–2.33)	0.60
COPD	1.04 (0.64–1.70)	0.87	1.04 (0.60–1.82)	0.89
Chronic renal failure	–	–	–	–
Severe AP vs mild AP
Age, years	1.02 (1.01–1.03)	0.01	1.01 (0.98–1.03)	0.60
Gender, M/F	1.10 (0.86–1.41)	0.45	1.32 (0.98–1.73)	0.09
Causes of the disease
Alcohol	1.01 (0.76–1.33)	0.95	3.14 (1.76–5.63)	0.00
Biliary	1.02 (0.79–1.31)	0.88	2.65 (1.56–4.51)	0.00
Others	–	–	–	–
Idiopathic	0.32 (0.20–0.51)	0.00	0.76 (0.59–0.98)	0.03
Most frequent concomitant diseases
Hypertension	1.48 (1.16–1.88)	0.00	1.48 (1.04–2.11)	0.03
Coronary heart disease	1.19 (0.95–1.65)	0.31	0.77 (0.47–1.25)	0.29
Diabetes mellitus type 2	1.23 (0.83–1.83)	0.29	1.56 (0.98–2.47)	0.06
Diabetes mellitus type 1	2.07 (1.14–3.75)	0.02	2.95 (1.50–5.80)	0.00
Circulatory failure	1.99 (1.36–2.91)	0.00	2.29 (1.36–3.86)	0.00
Atrial fibrillation	1.40 (0.86–2.30)	0.18	0.97 (0.48–1.95)	0.94
Degenerative joint disease	1.32 (0.71–2.46)	0.38	0.84 (0.27–2.64)	0.77
COPD	1.30 (0.75–2.23)	0.35	1.19 (0.62–2.26)	0.60
Chronic renal failure	2.07 (1.14–3.75)	0.02	1.28 (0.52–3.15)	0.59

Note: Statistically significant differences were indicated in bold type.

Abbreviations: AP, acute pancreatitis; F, female; M, male.

Table 3 Duration of a hospital stay due to AP in the older patients, compared to the younger ones, in due consideration of the severity of the disease

Variables	Hospital stay (days) Patients aged <65 years		Hospital stay (days) Patients aged ≥65–79 years		Hospital stay (days) Patients aged ≥80 years		P-value
	$\overline{x}(\text{SD})$	Me (Q1–Q3)	$\overline{x}(\text{SD})$	Me (Q1–Q3)	$\overline{x}(\text{SD})$	Me (Q1–Q3)
Mild AP	6.51 (3.61)	6.0 (4.0–8.0)	8.05 (4.11)	7.0 (5.0–9.0)	8.62 (4.27)	8.0 (6.0–10.0)	0.00
Moderate AP	17.04 (12.49)	15.0 (7.0–21.0)	14.38 (7.37)	12.5 (9.0–21.0)	9.90 (3.57)	15.0 (7.0–21.0)	0.03a
Severe AP	15.20 (19.94)	9.0 (1.0–21.0)	8.40 (6.19)	9.0 (2.0–13.0)	11.00 (12.32)	5.0 (3.0–12.0)	0.74
Hospitalization terminated by death	5.86 (11.41)	6.0 (1.0–9.0)	6.11 (6.41)	4.0 (1.0–9.0)	11.36 (13.56)	5.0 (2.0–21.0)	0.62

Notes:

a Median test. Statistically significant differences were indicated in bold type.

Abbreviations: AP, acute pancreatitis; Me, Median.

Table 4 Comparison of the laboratory tests results in the patients with acute pancreatitis, as stratified by age

	Patients aged <65 years		Patients aged 65–79 years		Patients aged ≥80 years		P-value
	$\overline{x}(\text{SD})$	Me (Q1–Q3)	$\overline{x}(\text{SD})$	Me (Q1–Q3)	$\overline{x}(\text{SD})$	Me (Q1–Q3)
Hematocrit (%)	43.47 (5.7)	43.70 (40.70–47.10)	41.96 (4.6)	41.95 (39.50–45.15)	41.21 (4.4)	41.40 (38.35–43.60)	0.00
HGB	14.74 (2.1)	14.90 (13.60–16.00)	14.08 (1.7)	14.00 (13.20–5.20)	13.79 (1.5)	13.80 (12.90–14.80)	0.00
WBC (×10^3/dL)	12.55 (6.0)	11.75 (8.80–14.90)	12.21 (4.8)	11.85 (8.80–14.50)	13.12 (7.6)	11.65 (9.06–15.35)	NS
Sodium (mmol/L)	136.53 (7.1)	137.00 (134.00–140.00)	138.27 (3.9)	139.00 (136.70–140.90)	138.65 (3.6)	139.00 (136.00–141.20)	0.00
Potassium (mmol/L)	4.31 (5.0)	4.09 (3.80–4.42)	4.09 (0.5)	4.10 (3.72–4.40)	4.10 (0.1)	4.10 (3.72–4.47)	NS
Amylase (U/L)	768.51 (1,076.9)	326.00 (143.0–978.00)	1,229.44 (1,087.9)	936.20 (394.70–1,722.60)	1,263.02 (1,063.1)	1,068 (396.00–1,791.00)	0.00
CRP (mg/dL)	73.62 (102.1)	20.00 (4.52–115.85)	49.40 (67.9)	17.30 (5.00–62.49)	43.13 (67.0)	16.40 (4.08–47.90)	NS
Creatinine (mg/dL)	1.19 (4.3)	0.87 (0.73–1.05)	1.02 (0.4)	0.92 (0.77–1.16)	1.21 (0.5)	1.11 (0.88–1.45)	0.00
BUN (mg/dL)	15.01 (8.50)	13.43 (10.28–17.75)	20.23 (9.6)	18.22 (14.49–24.25)	27.37 (14.0)	25.05 (17.19–32.29)	0.00
Glucose (mmol/L)	7.55 (2.9)	6.55 (5.77–8.50)	7.96 (2.8)	7.33 (6.05–9.11)	8.10 (2.6)	8.08 (6.05–9.25)	0.04
APACHE II	3.88 (2.3)	3.00 (2.00–5.00)	7.49 (2.8)	7.00 (6.00–9.00)	8.99 (3.0)	8.00 (7.00–10.00)	0.00

Note: Statistically significant differences were indicated in bold type.

Abbreviations: APACHE II, Acute Physiology and Chronic Health Evaluation II; BUN, blood urea nitrogen; CRP, C-reactive protein; HGB, hemoglobin; WBCs, white blood cells; NS, non-significant.