Acute pancreatitis:: A prospective study of its incidence, aetiology, severity, and mortality in Iceland

Objective: To evaluate the incidence, aetiology, severity and mortality of patients with acute pancreatitis. Design: Prospective study. Setting: University hospital, Iceland. Patients and methods: All 50 patients diagnosed with acute pancreatitis during the one-year period October 1998-September 1999 inclusive. Main outcome measures: APACHE II, and Ranson and Imrie scores, and C-reactive protein (CRP) concentrations. The Balthazar-Ranson criteria were used for scoring of computed tomograms (CT). Results: 27 of the 50 patients were male. The median age of the whole series was 60 years (range 19-85). The estimated incidence was 32/100000 for the first attack of acute pancreatitis. The causes were; gallstones 21 (42%), alcohol 16 (32%), miscellaneous 12 (24%), and idiopathic 1 (2%). 15 (33%) of the patients had APACHE II scores greater than or equal to9, 17 (38%) had Ranson scores of greater than or equal to3, 23 (50%) had Imrie scores of greater than or equal to3, and 16 (34%) had CRP concentrations over 210 mg/L during the first 4 days or >120 mg/L during the first week. Seven patients had severe pancreatitis. 2 patients in the whole group died, and both had clinically severe pancreatitis. Conclusions: This study indicates that the incidence of less severe acute pancreatitis is rising. Prospective assessment makes it possible to evaluate the aetiological factors more accurately. Measurement of the CRP concentration is an attractive and simple alternative to the severity scoring systems currently in use.