Does Etiology of Pancreatitis Matter? Differences in Outcomes Among Patients With Post–Endoscopic Retrograde Cholangiopancreatography, Acute Biliary, and Alcoholic Pancreatitis

Abstract

Objectives We compared outcomes of acute alcoholic pancreatitis (AAP), acute biliary pancreatitis (ABP), and post–endoscopic retrograde cholangiopancreatography pancreatitis (PEP). Methods This was a retrospective cohort study conducted at a tertiary care center between June 2007 and June 2012. Results A total of 300 (68%) patients were diagnosed with AAP, 88 (20%) with ABP, and 55 (12%) with PEP. Longer length of hospital stay (LOHS) was more common in ABP (23%) as compared with AAP (10%) and PEP (7%, P = 0.025). Pseudocyst (P = 0.048), organ failure (OF) (P = 0.01), need for interventions (P ⩽ 0.001), and mortality (P = 0.002) occurred more in ABP as compared with other groups. Systemic inflammatory response syndrome was associated with LOHS of more than 10 days (P = 0.01) and multi-OF (P = 0.05). Chronic pancreatitis was associated more with pseudocyst (P < 0.001) and mortality (P = 0.03). Serum urea nitrogen of greater than 25 g/dL predicted LOHS of more than 10 days (P = 0.02), OF (P < 0.001), multi-OF (P < 0.001), and persistent OF (P < 0.001). Conclusions Acute biliary pancreatitis is a more severe disease compared with PEP and AAP. Chronic pancreatitis, systemic inflammatory response syndrome, and high serum urea nitrogen are important predictors of morbidity.