4.7 Article

Danish Patients With Chronic Pancreatitis Have a Four-Fold Higher Mortality Rate Than the Danish Population

Journal

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
Volume 8, Issue 4, Pages 384-390

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.cgh.2009.12.016

Keywords

Chronic Pancreatitis; Mortality; Prospective Cohort Study; Prognostic Factors

Funding

  1. Hvidovre Hospital Research Foundation
  2. Solvay Pharma
  3. YKL-40 Foundation
  4. Foundation of 1870

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BACKGROUND & AIMS: We investigated mortality of patients with chronic pancreatitis (CP), compared with the Danish population and sought to determine whether clinical presentations of CP can be used in prognosis. We also investigated clinical factors associated with mortality and causes of death among these patients. METHODS: The Copenhagen Pancrearitis Study is a prospective study of patients admitted from 1977 to 1982 to the 5 main hospitals in Copenhagen with a diagnosis of acute pancreatitis or CP. In 2008, follow-up data were collected from these patients from the Danish Registries; this subcohort comprised 290 patients with probable (n = 41) or definite CP (n = 249). RESULTS: The mortality of patients with definite Cl was 4-fold that of the Danish population and significantly higher than that of patients with probable Cl (P = .003; 95% confidence interval [CI], 1.21-2.57); patients with probable CP had a 2- to 3-fold higher mortality rate than the population. In patients with definite CP, factors significantly associated with mortality included non-employment (P = .015; 95% CI, 0.53-0.93), and being underweight (P = .020; 95% CI, 0.52-0.95). Sex, alcohol use, smoking, single versus co-living, exocrine insufficiency, diabetes, pancreatic calcification, CP inheritance, painless CP, acute exacerbation of CP, or surgery for CP had no impact on survival. The most frequent causes of death were digestive diseases (19.5%), malignancies (19.5%), and cardiovascular diseases (11.3%). CONCLUSIONS: Danish patients with definite CP had a 4-fold higher mortality rate compared with the background population and a higher mortality rate than patients with probable CP. Being non-employed or underweight had significant impact on survival.

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