Worldwide Variations in Demographics, Management, and Outcomes of Acute Pancreatitis

Bassem Matta, Amir Gougol, Xiaotian Gao, Nageshwar Reddy, Rupjyoti Talukdar, Rakesh Kochhar, Mahesh Kumar Goenka, Aiste Gulla, Jose A. Gonzalez, Vikesh K. Singh, Miguel Ferreira, Tyler Stevens, Sorin T. Barbu, Haq Nawaz, Silvia C. Gutierrez, Narcis O. Zarnescu, Gabriele Capurso, Jeffrey Easler, Konstantinos Triantafyllou, Mario Pelaez-LunaShyam Thakkar, Carlos Ocampo, Enrique de-Madaria, Gregory A. Cote, Bechien U. Wu, Pedram Paragomi, Ioannis Pothoulakis, Gong Tang, Georgios I. Papachristou

Research output: Contribution to journalArticlepeer-review

Abstract

Background & Aims: Few studies have compared regional differences in acute pancreatitis. We analyzed data from an international registry of patients with acute pancreatitis to evaluate geographic variations in patient characteristics, management, and outcomes. Methods: We collected data from the APPRENTICE registry of patients with acute pancreatitis, which obtains information from patients in Europe (6 centers), India (3 centers), Latin America (5 centers), and North America (8 centers) using standardized questionnaires. Our final analysis included 1612 patients with acute pancreatitis (median age, 49 years; 53% male, 62% white) enrolled from August 2015 through January 2018. Results: Biliary (45%) and alcoholic acute pancreatitis (21%) were the most common etiologies. Based on the revised Atlanta classification, 65% of patients developed mild disease, 23% moderate, and 12% severe. The mean age of patients in Europe (58 years) was older than mean age for all 4 regions (46 years) and a higher proportion of patients in Europe had comorbid conditions (73% vs 50% overall). The predominant etiology of acute pancreatitis in Latin America was biliary (78%), whereas alcohol-associated pancreatitis accounted for the highest proportion of acute pancreatitis cases in India (45%). Pain was managed with opioid analgesics in 93% of patients in North America versus 27% of patients in the other 3 regions. Cholecystectomies were performed at the time of hospital admission for most patients in Latin America (60% vs 15% overall). A higher proportion of European patients with severe acute pancreatitis died during the original hospital stay (44%) compared with the other 3 regions (15%). Conclusions: We found significant variation in demographics, etiologies, management practices, and outcomes of acute pancreatitis worldwide. ClinicalTrials.gov number: NCT03075618.

Original languageEnglish
Pages (from-to)1567-1575.e2
JournalClinical Gastroenterology and Hepatology
Volume18
Issue number7
DOIs
Publication statusPublished - Jun 2020

Keywords

  • Drug
  • Inflammation
  • Pancreas
  • Treatment

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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