Diagnostic assessment and outcome of acute pancreatitis in Italy

Results of a prospective multicentre study. ProInf-AISP: Progetto informatizzato pancreatite acuta, Associazione Italiana Studio Pancreas, phase II

G. Uomo, R. Pezzilli, A. Gabbrielli, L. Castoldi, A. Zerbi, L. Frulloni, P. De Rai, G. Cavallini, V. Di Carlo, S. Agugiaro, L. Turri, A. Bartoli, F. Barberini, G. Cavazoni, F. Bartolo, D. Della Papa, C. Bassi, N. Bassi, M. Massani, A. Benedetti & 110 others G. Macarri, L. Piergallini, G. Briani, L. Bartolasi, L. Brugnano, G. M. Buonanno, C. Esposito, A. Cardovana, E. Cavina, M. Seccia, P. Lipollis, B. Musco, M. Barletta, E. Chilovi, A. De Guelmi, P. Chirletti, R. Caronna, S. Scozzafava, M. Cardi, E. Cirrino, A. Buffone, E. Colangelo, V. Caracino, F. Cortese, A. Cosentini, G. Costamagna, A. Tringali, M. Curzio, S. Clivio, S. Segato, A. D'Alessandro, V. Ambrosini, B. D'Amborsio, C. Chiodo, M. Dicillo, L. Reale, A. Grandolfo, P. Fabbrucci, A. Bruscino, P. Mugnaini, S. Ferrarese, I. Ugenti, G. B. Forte, P. Rocco, A. Franzè, A. Bertelè, G. Sereni, D. Friedman, L. M. Mariani, F. Murelli, V. Gai, C. Antro, D. Garcea, A. Gardini, E. Lucci, P. C. Giulianotti, F. Sbrana, T. Balestracci, S. M. Giulini, A. Pellizzari, M. Ronconi, S. Cimaschi, M. Grassini, S. Lacitignola, L. Caliandro, R. Mazzitelli, S. M. Costarella, A. Egidio, P. Mello Teggia, E. Stefano, P. Cassini, G. Modica, F. Lupo, G. Giraci, F. Mosca, M. Del Chiaro, G. Mosella, G. Benassai, M. Nanni, A. D'Aristotile, P. Negro, A. Pirazzoli, P. G. Rabitti, C. Romano, G. Gerardi, B. Troianello, D. Russello, A. Di Stefano, S. Avelli, M. Salvai, N. Bellini, P. Scalon, C. Staudacher, D. Parolini, M. Strazzabosco, S. Signorelli, U. Tedeschi, P. A. Testoni, E. Masci, A. Mariani, E. Torelli, M. R. Garcea, V. Lombardi, L. Cecconi, A. Valeri, L. Presenti, F. Alessio, M. Ventrucci, S. Virzì, A. Cipolla

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background and aim: Up till now, only one study providing practically complete information on acute pancreatitis in Italy has been published. The aim of this prospective study was to evaluate the clinical characteristics, in terms of diagnostic assessment and outcome, of a large series of patients affected by acute pancreatitis in Italy. Materials and methods: The study involved 56 Italian centres, homogeneously distributed throughout the entire national territory. Each participating centre was furnished with an ad hoc software including 530 items along with subsequent collection, tabulation and quality control of the data. Results: One thousand five hundred and forty case report forms of patients affected by acute pancreatitis were collected but 367 of them (24%) were subsequently eliminated from the final analysis. Therefore, 1173 patients (581 females and 592 males) were recruited. Mean age of patients was 62.0 ± 18.2 years (95% confidence interval, 60.9-63.0). On the basis of Atlanta classification, 1006 patients (85.8%) were defined as mild and 167 (14.2%) as severe pancreatitis. Biliary forms represented the most frequent aetiological category (813 cases, 69.3%) while alcoholic forms only 6.6% (77 cases); the remaining aetiologies accounted for 7.1% (83 cases) while 200 cases (17.1%) remained without a definite aetiological factor. Complete recovery was achieved in 1016 patients (86.6%) whereas morphological sequelae were found in 121 patients (10.3%) and mortality in 36 patients (3.1%; 0.4% in mild and 19.2% in severe acute pancreatitis). Ultrasonography was largely utilised as a first line diagnostic tool in all patients, with valuable visualisation of the pancreas in 85% of patients. Computer tomography scan was also widely used, with 66.7% of exams in mild and 33.3% in severe pancreatitis. Patients affected by biliary pancreatitis presented more severe (p = 0.004) and necrotizing forms (p = 0.021). Mortality was significantly related (p <0.001) with the extension of pancreatic necrosis and with an age of over 70 years. Body mass index presented significantly greater values in severe than in mild forms (p <0.001). Conclusions: Association of creatinine serum level over 2 mg/dl with an abnormal chest X-ray showed a high significant correlation with a more severe outcome in terms of morphological sequalae and mortality (p = 0.0001). Acute pancreatitis in Italy more commonly presents biliary aetiology and favourable outcome with low rate of complications and mortality. From a cost-effectiveness standpoint, diagnostic approach to this disease needs to be better standardised.

Original languageEnglish
Pages (from-to)829-837
Number of pages9
JournalDigestive and Liver Disease
Volume39
Issue number9
DOIs
Publication statusPublished - Sep 2007

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Pancreatitis
Italy
Multicenter Studies
Pancreas
Outcome Assessment (Health Care)
Prospective Studies
Mortality
Quality Control
Cost-Benefit Analysis
Ultrasonography
Creatinine
Body Mass Index
Necrosis
Thorax
Software
Tomography
X-Rays
Confidence Intervals

Keywords

  • Acute Pancreatitis
  • Clinical outcome
  • Computed tomography
  • Diagnosis
  • Pancreatic necrosis
  • Pancreatitis
  • Prognosis
  • Ultrasonography

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Diagnostic assessment and outcome of acute pancreatitis in Italy : Results of a prospective multicentre study. ProInf-AISP: Progetto informatizzato pancreatite acuta, Associazione Italiana Studio Pancreas, phase II. / Uomo, G.; Pezzilli, R.; Gabbrielli, A.; Castoldi, L.; Zerbi, A.; Frulloni, L.; De Rai, P.; Cavallini, G.; Di Carlo, V.; Agugiaro, S.; Turri, L.; Bartoli, A.; Barberini, F.; Cavazoni, G.; Bartolo, F.; Della Papa, D.; Bassi, C.; Bassi, N.; Massani, M.; Benedetti, A.; Macarri, G.; Piergallini, L.; Briani, G.; Bartolasi, L.; Brugnano, L.; Buonanno, G. M.; Esposito, C.; Cardovana, A.; Cavina, E.; Seccia, M.; Lipollis, P.; Musco, B.; Barletta, M.; Chilovi, E.; De Guelmi, A.; Chirletti, P.; Caronna, R.; Scozzafava, S.; Cardi, M.; Cirrino, E.; Buffone, A.; Colangelo, E.; Caracino, V.; Cortese, F.; Cosentini, A.; Costamagna, G.; Tringali, A.; Curzio, M.; Clivio, S.; Segato, S.; D'Alessandro, A.; Ambrosini, V.; D'Amborsio, B.; Chiodo, C.; Dicillo, M.; Reale, L.; Grandolfo, A.; Fabbrucci, P.; Bruscino, A.; Mugnaini, P.; Ferrarese, S.; Ugenti, I.; Forte, G. B.; Rocco, P.; Franzè, A.; Bertelè, A.; Sereni, G.; Friedman, D.; Mariani, L. M.; Murelli, F.; Gai, V.; Antro, C.; Garcea, D.; Gardini, A.; Lucci, E.; Giulianotti, P. C.; Sbrana, F.; Balestracci, T.; Giulini, S. M.; Pellizzari, A.; Ronconi, M.; Cimaschi, S.; Grassini, M.; Lacitignola, S.; Caliandro, L.; Mazzitelli, R.; Costarella, S. M.; Egidio, A.; Mello Teggia, P.; Stefano, E.; Cassini, P.; Modica, G.; Lupo, F.; Giraci, G.; Mosca, F.; Del Chiaro, M.; Mosella, G.; Benassai, G.; Nanni, M.; D'Aristotile, A.; Negro, P.; Pirazzoli, A.; Rabitti, P. G.; Romano, C.; Gerardi, G.; Troianello, B.; Russello, D.; Di Stefano, A.; Avelli, S.; Salvai, M.; Bellini, N.; Scalon, P.; Staudacher, C.; Parolini, D.; Strazzabosco, M.; Signorelli, S.; Tedeschi, U.; Testoni, P. A.; Masci, E.; Mariani, A.; Torelli, E.; Garcea, M. R.; Lombardi, V.; Cecconi, L.; Valeri, A.; Presenti, L.; Alessio, F.; Ventrucci, M.; Virzì, S.; Cipolla, A.

In: Digestive and Liver Disease, Vol. 39, No. 9, 09.2007, p. 829-837.

Research output: Contribution to journalArticle

Uomo, G, Pezzilli, R, Gabbrielli, A, Castoldi, L, Zerbi, A, Frulloni, L, De Rai, P, Cavallini, G, Di Carlo, V, Agugiaro, S, Turri, L, Bartoli, A, Barberini, F, Cavazoni, G, Bartolo, F, Della Papa, D, Bassi, C, Bassi, N, Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Brugnano, L, Buonanno, GM, Esposito, C, Cardovana, A, Cavina, E, Seccia, M, Lipollis, P, Musco, B, Barletta, M, Chilovi, E, De Guelmi, A, Chirletti, P, Caronna, R, Scozzafava, S, Cardi, M, Cirrino, E, Buffone, A, Colangelo, E, Caracino, V, Cortese, F, Cosentini, A, Costamagna, G, Tringali, A, Curzio, M, Clivio, S, Segato, S, D'Alessandro, A, Ambrosini, V, D'Amborsio, B, Chiodo, C, Dicillo, M, Reale, L, Grandolfo, A, Fabbrucci, P, Bruscino, A, Mugnaini, P, Ferrarese, S, Ugenti, I, Forte, GB, Rocco, P, Franzè, A, Bertelè, A, Sereni, G, Friedman, D, Mariani, LM, Murelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, PC, Sbrana, F, Balestracci, T, Giulini, SM, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacitignola, S, Caliandro, L, Mazzitelli, R, Costarella, SM, Egidio, A, Mello Teggia, P, Stefano, E, Cassini, P, Modica, G, Lupo, F, Giraci, G, Mosca, F, Del Chiaro, M, Mosella, G, Benassai, G, Nanni, M, D'Aristotile, A, Negro, P, Pirazzoli, A, Rabitti, PG, Romano, C, Gerardi, G, Troianello, B, Russello, D, Di Stefano, A, Avelli, S, Salvai, M, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, PA, Masci, E, Mariani, A, Torelli, E, Garcea, MR, Lombardi, V, Cecconi, L, Valeri, A, Presenti, L, Alessio, F, Ventrucci, M, Virzì, S & Cipolla, A 2007, 'Diagnostic assessment and outcome of acute pancreatitis in Italy: Results of a prospective multicentre study. ProInf-AISP: Progetto informatizzato pancreatite acuta, Associazione Italiana Studio Pancreas, phase II', Digestive and Liver Disease, vol. 39, no. 9, pp. 829-837. https://doi.org/10.1016/j.dld.2007.05.009
Uomo, G. ; Pezzilli, R. ; Gabbrielli, A. ; Castoldi, L. ; Zerbi, A. ; Frulloni, L. ; De Rai, P. ; Cavallini, G. ; Di Carlo, V. ; Agugiaro, S. ; Turri, L. ; Bartoli, A. ; Barberini, F. ; Cavazoni, G. ; Bartolo, F. ; Della Papa, D. ; Bassi, C. ; Bassi, N. ; Massani, M. ; Benedetti, A. ; Macarri, G. ; Piergallini, L. ; Briani, G. ; Bartolasi, L. ; Brugnano, L. ; Buonanno, G. M. ; Esposito, C. ; Cardovana, A. ; Cavina, E. ; Seccia, M. ; Lipollis, P. ; Musco, B. ; Barletta, M. ; Chilovi, E. ; De Guelmi, A. ; Chirletti, P. ; Caronna, R. ; Scozzafava, S. ; Cardi, M. ; Cirrino, E. ; Buffone, A. ; Colangelo, E. ; Caracino, V. ; Cortese, F. ; Cosentini, A. ; Costamagna, G. ; Tringali, A. ; Curzio, M. ; Clivio, S. ; Segato, S. ; D'Alessandro, A. ; Ambrosini, V. ; D'Amborsio, B. ; Chiodo, C. ; Dicillo, M. ; Reale, L. ; Grandolfo, A. ; Fabbrucci, P. ; Bruscino, A. ; Mugnaini, P. ; Ferrarese, S. ; Ugenti, I. ; Forte, G. B. ; Rocco, P. ; Franzè, A. ; Bertelè, A. ; Sereni, G. ; Friedman, D. ; Mariani, L. M. ; Murelli, F. ; Gai, V. ; Antro, C. ; Garcea, D. ; Gardini, A. ; Lucci, E. ; Giulianotti, P. C. ; Sbrana, F. ; Balestracci, T. ; Giulini, S. M. ; Pellizzari, A. ; Ronconi, M. ; Cimaschi, S. ; Grassini, M. ; Lacitignola, S. ; Caliandro, L. ; Mazzitelli, R. ; Costarella, S. M. ; Egidio, A. ; Mello Teggia, P. ; Stefano, E. ; Cassini, P. ; Modica, G. ; Lupo, F. ; Giraci, G. ; Mosca, F. ; Del Chiaro, M. ; Mosella, G. ; Benassai, G. ; Nanni, M. ; D'Aristotile, A. ; Negro, P. ; Pirazzoli, A. ; Rabitti, P. G. ; Romano, C. ; Gerardi, G. ; Troianello, B. ; Russello, D. ; Di Stefano, A. ; Avelli, S. ; Salvai, M. ; Bellini, N. ; Scalon, P. ; Staudacher, C. ; Parolini, D. ; Strazzabosco, M. ; Signorelli, S. ; Tedeschi, U. ; Testoni, P. A. ; Masci, E. ; Mariani, A. ; Torelli, E. ; Garcea, M. R. ; Lombardi, V. ; Cecconi, L. ; Valeri, A. ; Presenti, L. ; Alessio, F. ; Ventrucci, M. ; Virzì, S. ; Cipolla, A. / Diagnostic assessment and outcome of acute pancreatitis in Italy : Results of a prospective multicentre study. ProInf-AISP: Progetto informatizzato pancreatite acuta, Associazione Italiana Studio Pancreas, phase II. In: Digestive and Liver Disease. 2007 ; Vol. 39, No. 9. pp. 829-837.
@article{972db572f644473d9692f3253e8c587a,
title = "Diagnostic assessment and outcome of acute pancreatitis in Italy: Results of a prospective multicentre study. ProInf-AISP: Progetto informatizzato pancreatite acuta, Associazione Italiana Studio Pancreas, phase II",
abstract = "Background and aim: Up till now, only one study providing practically complete information on acute pancreatitis in Italy has been published. The aim of this prospective study was to evaluate the clinical characteristics, in terms of diagnostic assessment and outcome, of a large series of patients affected by acute pancreatitis in Italy. Materials and methods: The study involved 56 Italian centres, homogeneously distributed throughout the entire national territory. Each participating centre was furnished with an ad hoc software including 530 items along with subsequent collection, tabulation and quality control of the data. Results: One thousand five hundred and forty case report forms of patients affected by acute pancreatitis were collected but 367 of them (24{\%}) were subsequently eliminated from the final analysis. Therefore, 1173 patients (581 females and 592 males) were recruited. Mean age of patients was 62.0 ± 18.2 years (95{\%} confidence interval, 60.9-63.0). On the basis of Atlanta classification, 1006 patients (85.8{\%}) were defined as mild and 167 (14.2{\%}) as severe pancreatitis. Biliary forms represented the most frequent aetiological category (813 cases, 69.3{\%}) while alcoholic forms only 6.6{\%} (77 cases); the remaining aetiologies accounted for 7.1{\%} (83 cases) while 200 cases (17.1{\%}) remained without a definite aetiological factor. Complete recovery was achieved in 1016 patients (86.6{\%}) whereas morphological sequelae were found in 121 patients (10.3{\%}) and mortality in 36 patients (3.1{\%}; 0.4{\%} in mild and 19.2{\%} in severe acute pancreatitis). Ultrasonography was largely utilised as a first line diagnostic tool in all patients, with valuable visualisation of the pancreas in 85{\%} of patients. Computer tomography scan was also widely used, with 66.7{\%} of exams in mild and 33.3{\%} in severe pancreatitis. Patients affected by biliary pancreatitis presented more severe (p = 0.004) and necrotizing forms (p = 0.021). Mortality was significantly related (p <0.001) with the extension of pancreatic necrosis and with an age of over 70 years. Body mass index presented significantly greater values in severe than in mild forms (p <0.001). Conclusions: Association of creatinine serum level over 2 mg/dl with an abnormal chest X-ray showed a high significant correlation with a more severe outcome in terms of morphological sequalae and mortality (p = 0.0001). Acute pancreatitis in Italy more commonly presents biliary aetiology and favourable outcome with low rate of complications and mortality. From a cost-effectiveness standpoint, diagnostic approach to this disease needs to be better standardised.",
keywords = "Acute Pancreatitis, Clinical outcome, Computed tomography, Diagnosis, Pancreatic necrosis, Pancreatitis, Prognosis, Ultrasonography",
author = "G. Uomo and R. Pezzilli and A. Gabbrielli and L. Castoldi and A. Zerbi and L. Frulloni and {De Rai}, P. and G. Cavallini and {Di Carlo}, V. and S. Agugiaro and L. Turri and A. Bartoli and F. Barberini and G. Cavazoni and F. Bartolo and {Della Papa}, D. and C. Bassi and N. Bassi and M. Massani and A. Benedetti and G. Macarri and L. Piergallini and G. Briani and L. Bartolasi and L. Brugnano and Buonanno, {G. M.} and C. Esposito and A. Cardovana and E. Cavina and M. Seccia and P. Lipollis and B. Musco and M. Barletta and E. Chilovi and {De Guelmi}, A. and P. Chirletti and R. Caronna and S. Scozzafava and M. Cardi and E. Cirrino and A. Buffone and E. Colangelo and V. Caracino and F. Cortese and A. Cosentini and G. Costamagna and A. Tringali and M. Curzio and S. Clivio and S. Segato and A. D'Alessandro and V. Ambrosini and B. D'Amborsio and C. Chiodo and M. Dicillo and L. Reale and A. Grandolfo and P. Fabbrucci and A. Bruscino and P. Mugnaini and S. Ferrarese and I. Ugenti and Forte, {G. B.} and P. Rocco and A. Franz{\`e} and A. Bertel{\`e} and G. Sereni and D. Friedman and Mariani, {L. M.} and F. Murelli and V. Gai and C. Antro and D. Garcea and A. Gardini and E. Lucci and Giulianotti, {P. C.} and F. Sbrana and T. Balestracci and Giulini, {S. M.} and A. Pellizzari and M. Ronconi and S. Cimaschi and M. Grassini and S. Lacitignola and L. Caliandro and R. Mazzitelli and Costarella, {S. M.} and A. Egidio and {Mello Teggia}, P. and E. Stefano and P. Cassini and G. Modica and F. Lupo and G. Giraci and F. Mosca and {Del Chiaro}, M. and G. Mosella and G. Benassai and M. Nanni and A. D'Aristotile and P. Negro and A. Pirazzoli and Rabitti, {P. G.} and C. Romano and G. Gerardi and B. Troianello and D. Russello and {Di Stefano}, A. and S. Avelli and M. Salvai and N. Bellini and P. Scalon and C. Staudacher and D. Parolini and M. Strazzabosco and S. Signorelli and U. Tedeschi and Testoni, {P. A.} and E. Masci and A. Mariani and E. Torelli and Garcea, {M. R.} and V. Lombardi and L. Cecconi and A. Valeri and L. Presenti and F. Alessio and M. Ventrucci and S. Virz{\`i} and A. Cipolla",
year = "2007",
month = "9",
doi = "10.1016/j.dld.2007.05.009",
language = "English",
volume = "39",
pages = "829--837",
journal = "Digestive and Liver Disease",
issn = "1590-8658",
publisher = "Elsevier B.V.",
number = "9",

}

TY - JOUR

T1 - Diagnostic assessment and outcome of acute pancreatitis in Italy

T2 - Results of a prospective multicentre study. ProInf-AISP: Progetto informatizzato pancreatite acuta, Associazione Italiana Studio Pancreas, phase II

AU - Uomo, G.

AU - Pezzilli, R.

AU - Gabbrielli, A.

AU - Castoldi, L.

AU - Zerbi, A.

AU - Frulloni, L.

AU - De Rai, P.

AU - Cavallini, G.

AU - Di Carlo, V.

AU - Agugiaro, S.

AU - Turri, L.

AU - Bartoli, A.

AU - Barberini, F.

AU - Cavazoni, G.

AU - Bartolo, F.

AU - Della Papa, D.

AU - Bassi, C.

AU - Bassi, N.

AU - Massani, M.

AU - Benedetti, A.

AU - Macarri, G.

AU - Piergallini, L.

AU - Briani, G.

AU - Bartolasi, L.

AU - Brugnano, L.

AU - Buonanno, G. M.

AU - Esposito, C.

AU - Cardovana, A.

AU - Cavina, E.

AU - Seccia, M.

AU - Lipollis, P.

AU - Musco, B.

AU - Barletta, M.

AU - Chilovi, E.

AU - De Guelmi, A.

AU - Chirletti, P.

AU - Caronna, R.

AU - Scozzafava, S.

AU - Cardi, M.

AU - Cirrino, E.

AU - Buffone, A.

AU - Colangelo, E.

AU - Caracino, V.

AU - Cortese, F.

AU - Cosentini, A.

AU - Costamagna, G.

AU - Tringali, A.

AU - Curzio, M.

AU - Clivio, S.

AU - Segato, S.

AU - D'Alessandro, A.

AU - Ambrosini, V.

AU - D'Amborsio, B.

AU - Chiodo, C.

AU - Dicillo, M.

AU - Reale, L.

AU - Grandolfo, A.

AU - Fabbrucci, P.

AU - Bruscino, A.

AU - Mugnaini, P.

AU - Ferrarese, S.

AU - Ugenti, I.

AU - Forte, G. B.

AU - Rocco, P.

AU - Franzè, A.

AU - Bertelè, A.

AU - Sereni, G.

AU - Friedman, D.

AU - Mariani, L. M.

AU - Murelli, F.

AU - Gai, V.

AU - Antro, C.

AU - Garcea, D.

AU - Gardini, A.

AU - Lucci, E.

AU - Giulianotti, P. C.

AU - Sbrana, F.

AU - Balestracci, T.

AU - Giulini, S. M.

AU - Pellizzari, A.

AU - Ronconi, M.

AU - Cimaschi, S.

AU - Grassini, M.

AU - Lacitignola, S.

AU - Caliandro, L.

AU - Mazzitelli, R.

AU - Costarella, S. M.

AU - Egidio, A.

AU - Mello Teggia, P.

AU - Stefano, E.

AU - Cassini, P.

AU - Modica, G.

AU - Lupo, F.

AU - Giraci, G.

AU - Mosca, F.

AU - Del Chiaro, M.

AU - Mosella, G.

AU - Benassai, G.

AU - Nanni, M.

AU - D'Aristotile, A.

AU - Negro, P.

AU - Pirazzoli, A.

AU - Rabitti, P. G.

AU - Romano, C.

AU - Gerardi, G.

AU - Troianello, B.

AU - Russello, D.

AU - Di Stefano, A.

AU - Avelli, S.

AU - Salvai, M.

AU - Bellini, N.

AU - Scalon, P.

AU - Staudacher, C.

AU - Parolini, D.

AU - Strazzabosco, M.

AU - Signorelli, S.

AU - Tedeschi, U.

AU - Testoni, P. A.

AU - Masci, E.

AU - Mariani, A.

AU - Torelli, E.

AU - Garcea, M. R.

AU - Lombardi, V.

AU - Cecconi, L.

AU - Valeri, A.

AU - Presenti, L.

AU - Alessio, F.

AU - Ventrucci, M.

AU - Virzì, S.

AU - Cipolla, A.

PY - 2007/9

Y1 - 2007/9

N2 - Background and aim: Up till now, only one study providing practically complete information on acute pancreatitis in Italy has been published. The aim of this prospective study was to evaluate the clinical characteristics, in terms of diagnostic assessment and outcome, of a large series of patients affected by acute pancreatitis in Italy. Materials and methods: The study involved 56 Italian centres, homogeneously distributed throughout the entire national territory. Each participating centre was furnished with an ad hoc software including 530 items along with subsequent collection, tabulation and quality control of the data. Results: One thousand five hundred and forty case report forms of patients affected by acute pancreatitis were collected but 367 of them (24%) were subsequently eliminated from the final analysis. Therefore, 1173 patients (581 females and 592 males) were recruited. Mean age of patients was 62.0 ± 18.2 years (95% confidence interval, 60.9-63.0). On the basis of Atlanta classification, 1006 patients (85.8%) were defined as mild and 167 (14.2%) as severe pancreatitis. Biliary forms represented the most frequent aetiological category (813 cases, 69.3%) while alcoholic forms only 6.6% (77 cases); the remaining aetiologies accounted for 7.1% (83 cases) while 200 cases (17.1%) remained without a definite aetiological factor. Complete recovery was achieved in 1016 patients (86.6%) whereas morphological sequelae were found in 121 patients (10.3%) and mortality in 36 patients (3.1%; 0.4% in mild and 19.2% in severe acute pancreatitis). Ultrasonography was largely utilised as a first line diagnostic tool in all patients, with valuable visualisation of the pancreas in 85% of patients. Computer tomography scan was also widely used, with 66.7% of exams in mild and 33.3% in severe pancreatitis. Patients affected by biliary pancreatitis presented more severe (p = 0.004) and necrotizing forms (p = 0.021). Mortality was significantly related (p <0.001) with the extension of pancreatic necrosis and with an age of over 70 years. Body mass index presented significantly greater values in severe than in mild forms (p <0.001). Conclusions: Association of creatinine serum level over 2 mg/dl with an abnormal chest X-ray showed a high significant correlation with a more severe outcome in terms of morphological sequalae and mortality (p = 0.0001). Acute pancreatitis in Italy more commonly presents biliary aetiology and favourable outcome with low rate of complications and mortality. From a cost-effectiveness standpoint, diagnostic approach to this disease needs to be better standardised.

AB - Background and aim: Up till now, only one study providing practically complete information on acute pancreatitis in Italy has been published. The aim of this prospective study was to evaluate the clinical characteristics, in terms of diagnostic assessment and outcome, of a large series of patients affected by acute pancreatitis in Italy. Materials and methods: The study involved 56 Italian centres, homogeneously distributed throughout the entire national territory. Each participating centre was furnished with an ad hoc software including 530 items along with subsequent collection, tabulation and quality control of the data. Results: One thousand five hundred and forty case report forms of patients affected by acute pancreatitis were collected but 367 of them (24%) were subsequently eliminated from the final analysis. Therefore, 1173 patients (581 females and 592 males) were recruited. Mean age of patients was 62.0 ± 18.2 years (95% confidence interval, 60.9-63.0). On the basis of Atlanta classification, 1006 patients (85.8%) were defined as mild and 167 (14.2%) as severe pancreatitis. Biliary forms represented the most frequent aetiological category (813 cases, 69.3%) while alcoholic forms only 6.6% (77 cases); the remaining aetiologies accounted for 7.1% (83 cases) while 200 cases (17.1%) remained without a definite aetiological factor. Complete recovery was achieved in 1016 patients (86.6%) whereas morphological sequelae were found in 121 patients (10.3%) and mortality in 36 patients (3.1%; 0.4% in mild and 19.2% in severe acute pancreatitis). Ultrasonography was largely utilised as a first line diagnostic tool in all patients, with valuable visualisation of the pancreas in 85% of patients. Computer tomography scan was also widely used, with 66.7% of exams in mild and 33.3% in severe pancreatitis. Patients affected by biliary pancreatitis presented more severe (p = 0.004) and necrotizing forms (p = 0.021). Mortality was significantly related (p <0.001) with the extension of pancreatic necrosis and with an age of over 70 years. Body mass index presented significantly greater values in severe than in mild forms (p <0.001). Conclusions: Association of creatinine serum level over 2 mg/dl with an abnormal chest X-ray showed a high significant correlation with a more severe outcome in terms of morphological sequalae and mortality (p = 0.0001). Acute pancreatitis in Italy more commonly presents biliary aetiology and favourable outcome with low rate of complications and mortality. From a cost-effectiveness standpoint, diagnostic approach to this disease needs to be better standardised.

KW - Acute Pancreatitis

KW - Clinical outcome

KW - Computed tomography

KW - Diagnosis

KW - Pancreatic necrosis

KW - Pancreatitis

KW - Prognosis

KW - Ultrasonography

UR - http://www.scopus.com/inward/record.url?scp=34547681809&partnerID=8YFLogxK

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U2 - 10.1016/j.dld.2007.05.009

DO - 10.1016/j.dld.2007.05.009

M3 - Article

VL - 39

SP - 829

EP - 837

JO - Digestive and Liver Disease

JF - Digestive and Liver Disease

SN - 1590-8658

IS - 9

ER -