Acute pancreatitis in the Guangdong Province, China

Background/ Aims: Many studies have recently been published on acute pancreatitis; however, few large-sample studies have been focused on the risk factors for deaths in severe acute pancreatitis. To address this issue, the present study was intended to assess etiology, severity, and mortality of acute pancreatitis in the Guangdong Province (Guangdong), China, and to analyze the risk factors responsible for deaths in severe acute pancreatitis in this large series of patients. Methods: Four tertiary medical centers located in Guangdong were involved in this retrospective study. Data of 2,342 patients with acute pancreatitis admitted to these centers from December 1990 through December 2005 were collected in a standardized form and analyzed. Results: Of the 2,342 patients (1,130 men and 1,212 women, mean age 51 +/- 18, range 4 - 98 years), 1,778 (76.0%) had mild pancreatitis, and 564 (24.0%) had the severe form. Biliary tract disease (47.5%) was the predominant etiology, the overall mortality rate was 5.0%, and the fatality rate in patients with severe acute pancreatitis was 20.0%. Among the deceased patients in the severe acute pancreatitis group, logistic regression analysis of variables showed that the independent risk factor for mortality was shock, while a biliary origin was a protective factor against a poor prognosis. Conclusions: In this case series, the results suggest that biliary tract disease was the main etiologic factor of acute pancreatitis in Guangdong. The majority of deaths in severe acute pancreatitis occurred within the first 14 days of admission; the only independent risk factor for mortality was systematic complication of shock.