Prognosis of chronic pancreatitis: An international multicenter study

A. B. Lowenfels, P. Maisonneuve, G. Cavallini, R. W. Ammann, P. G. Lankisch, J. R. Andersen, E. P. DiMagno, A. Andren-Sandberg, L. Domellof, V. Di Francesco, P. Pederzoli, A. Lohr-Happe, E. Krag, P. Boyle, C. S. Pitchumoni, Shein Wynn Pe Shein Wynn, L. J. Melton

Research output: Contribution to journalArticle

Abstract

Objectives: The aim of this study was to determine which factors predict mortality in a cohort of patients with chronic alcoholic and nonalcoholic pancreatitis. Patients with chronic pancreatitis are known to have a reduced life expectancy, but the quantitative relationship between various clinical features and survival is unclear. Methods: We evaluated survival among 2015 subjects with chronic pancreatitis treated at seven centers located in six countries. Results: Mean age at diagnosis was 46 ± 13 yr and mean duration of follow-up was 7.4 ± 6.2 yr. Overall survival at 10 yr was 70% (95% confidence interval (CI), 68-73%) and at 20 yr was 45% (95% CI, 41-49%). Survival was significantly less than in the background population. There were 559 deaths observed among those with chronic pancreatitis compared with an expected number of 157.4, yielding a standardized mortality ratio (SMR) of 3.6 (95% CI, 3.3-3.9). Older subjects and those with alcoholic pancreatitis had a significant reduction in survival. In a multivariate analysis, mortality of middle-aged and older subjects was 2.3 (95% CI, 1.8-2.8) and 6.3 (95% CI, 4.7-8.3) times greater than subjects less than 40 yr at diagnosis. Smoking (hazard ratio, 1.4; 95% CI, 1.0-1.9), drinking (hazard ratio, 1.6; 95% CI, 1.2-2.2), or development of cirrhosis (hazard ratio, 2.5; 95% CI, 2.0-3.2) increased the risk of death during the observation period, but we observed no survival difference in operated vs. nonoperated patients. Conclusions: Age at diagnosis, smoking, and drinking are major predictors of mortality in patients with chronic pancreatitis.

Original languageEnglish
Pages (from-to)1467-1471
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume89
Issue number9
Publication statusPublished - 1994

ASJC Scopus subject areas

  • Gastroenterology

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    Lowenfels, A. B., Maisonneuve, P., Cavallini, G., Ammann, R. W., Lankisch, P. G., Andersen, J. R., DiMagno, E. P., Andren-Sandberg, A., Domellof, L., Di Francesco, V., Pederzoli, P., Lohr-Happe, A., Krag, E., Boyle, P., Pitchumoni, C. S., Pe Shein Wynn, S. W., & Melton, L. J. (1994). Prognosis of chronic pancreatitis: An international multicenter study. American Journal of Gastroenterology, 89(9), 1467-1471.