Can you Die from Acute Pancreatitis: 6 Facts & Statistics.
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Death from acute pancreatitis is less than 2%. The most common risk factors include older age, obesity, severe symptoms, and the presence of organ failure.
Here are 6 facts and statistics that will explain the risk of death from acute pancreatitis.
1. 15-25% of patients with acute pancreatitis will have severe pancreatitis.
The pancreas is a small organ that lies on the left upper abdomen behind your stomach.
The pancreas is mainly responsible for creating and secreting the digestive enzymes that break down fat, protein, and carbohydrates.
The pancreas secretes its digestive enzymes through small ducts into the duodenum.
The most common cause of acute pancreatitis is an obstruction to its ducts (as with small gallstones or tumors obstructing its opening).
The episode of acute pancreatitis often causes severe pain, vomiting, and sometimes fever.
The majority of the cases of acute pancreatitis improve within a few days of treatment.
However, about 15-25% of the cases of acute pancreatitis are moderately severe or severe (reference).
Severe acute pancreatitis is a life-threatening condition as the digestive enzymes may destroy the pancreas and the surrounding tissues (the body digests itself).
Death from acute pancreatitis is associated with a severe type of pancreatitis.
To determine the severity of acute pancreatitis, which determines death risk, doctors use a scoring system.
There are many different scoring systems; The two widely used scoring systems are the APACHE II score and Ranson’s criteria.
For example, Ranson’s criteria is a scoring system at the time of presentation (0 hours) and after 48 hours of diagnosis of pancreatitis.
These criteria include age, Oxygen pressure in the arteries, the amount of fluid loss, and some laboratory tests such as white blood cell count, LDH, etc.
The mortality rate from acute pancreatitis raises significantly when the patients have four or more criteria.
The table below illustrates the full list of Ranson’s criteria.
2. Death from acute pancreatitis decreased to less than 2% in the USA.
Between 1988 and 2003, A large study in the USA found a dramatic drop in death rates from acute pancreatitis from 12% in 1988 to 2% in 2003 (reference).
The drop in the death rates from acute pancreatitis is due to advances in early diagnosis and better treatments and interventions for the disease.
Acute pancreatitis is not a horrific disease as it used to be before. Instead, the small fractions (less than 2%) that die from acute pancreatitis are often those with risk factors, comorbid conditions, or very old age.
3. Older age is a strong predictor of death from acute pancreatitis.
Many studies found that the risk of severe acute pancreatitis and death is higher in older people.
Several cutoff levels of age were used in the studies; most of them ranged from 55 to 75.
For example, one study concluded that patients with acute pancreatitis and above 75 years of age ( compared to patients aged 35 years old) have:
- 15-fold greater risk of dying within two weeks of acute pancreatitis, and
- 22-fold greater risk of dying within 91 days of acute pancreatitis.
Another study concluded that the severe acute pancreatitis death rate is less than 5% in the young. On the other hand, the elderly have a strikingly higher death rate from severe acute pancreatitis reaching about 25% (one in every four patients).
The reason behind the very high risk of death from acute pancreatitis are:
- Older people are more likely to have comorbidities such as diabetes, heart diseases, etc.
- The gradual decline in different organ functions.
- Slow and poor healing in the elderly.
- A general decline in the immune system function.
4. Mortality is higher among obese people with acute pancreatitis.
Obese people (with a body mass index (BMI) above 30) are at risk of developing a severe form of acute pancreatitis. You can calculate your BMI here.
Also, the risk for mortality was higher in patients with high BMI.
One large meta-analysis study found that obese people have:
- Three-fold greater risk for development of the severe form of acute pancreatitis.
- About four-fold greater risk for local complications of acute pancreatitis.
- More than a two-fold greater risk of death from acute pancreatitis.
Obesity is the mother of all diseases; Obese people often have other diseases such as diabetes, atherosclerosis, and heart diseases. These risk factors and comorbid diseases significantly increase the risk of death from acute pancreatitis.
5. Other clinical predictors of death from acute pancreatitis.
Other predictors of severe acute pancreatitis and death were found (other than age and obesity).
These predictors can be in the form of clinical symptoms or signs, laboratory findings, or radiological findings.
Here are the most common predictors of severe acute pancreatitis/death (reference):
A. Clinical predictors.
- Older ages (particularly those who are above the age of 75).
- Obese patients (BMI >30).
- Acute pancreatitis secondary to alcohol use.
- Severe tenderness and rebound tenderness over the pancreatic area.
- Organ failures (patients with liver cirrhosis, kidney failure, respiratory failure, etc.).
- Low blood pressure (Systolic blood pressure less than 90 mmHg).
- Low Oxygen saturation (a sign of respiratory failure).
B. Laboratory predictors.
- White blood cell count >16,000/mm3
- Blood glucose rises above 200 mg/dl.
- Higher CRP levels (>150 mg/L).
- LDH >350 U/L.
- AST (Aspartate aminotransferase) above 250.
- Serum creatinine rises above 1.8 mg/dL within the first 48 hours.
- Increased blood urea nitrogen >5 mg/dL.
- Fall of hematocrit by >10% within 48 hours of acute pancreatitis diagnosis.
- Procalcitonin levels above 86%.
Urine Color Changes in Pancreatitis (Acute & Chronic) & Pancreatic Cancer.
Lipase level charts in healthy and patients with pancreatitis.
C. Radiological predictors.
- Presence of pleural effusion in chest radiographs within the first 24 hours.
- Presences of a lung infiltrate in chest radiographs within the first 24 hours of acute pancreatitis.
- Diffuse necrosis of the pancreas and/or large fluid or gas collections inside the abdomen in CT or MRI.
6. Most common causes of death from acute pancreatitis.
- Respiratory system failure (pulmonary edema and congestion).
- Hemorrhagic pancreatitis (intra-abdominal bleeding due to severe acute pancreatitis).
- Infection (septicemia and septic shock).
- Acute renal failure.
- Heart failure.