Acute pancreatitis: A 7 year retrospective cohort study of the epidemiology, aetiology and outcome from a tertiary hospital in Jamaica

摘要

Background Acute pancreatitis (AP) is a significant cause of acute abdominal pain, morbidity and hospitalisation. There was previously a dearth of studies exploring the incidence, risk factors and outcome of AP in the Caribbean region. Materials and methods All patients with a diagnosis of AP admitted to the University Hospital of the West Indies (UHWI) between 2006 and 2012 were reviewed. The epidemiological profile, risk factors, clinical presentation and outcomes of patients with AP were retrospectively studied. Results There were 70 females and 21 males with a median age of 44 years (range 2–86). The median age of males was significantly higher than that of females (p?=?0.041). The incidence of AP was 74 per 100,000 admissions per year. Vomiting and abdominal tenderness were noted in the majority of patients. The most common aetiology was biliary disease (71.4%), idiopathic (12%), post-ERCP (6.6%) and alcohol (5.5%). Alcoholic pancreatitis was only seen in males whereas idiopathic and post-ERCP pancreatitis only occurred in females. The mean duration of hospitalisation was 9.51?±?8.28 days. Disease severity was mild in 61.1%, moderately severe in 26.7%, and severe in 12.2% of patients. Factors associated with more severe disease included overweight/obesity, idiopathic aetiology and post-ERCP status. The case fatality rate was 2%. Conclusion The incidence of AP was 74/100,000 hospital admissions annually. There was an unusual female preponderance, with biliary pancreatitis being the most common type occurring at an equal frequency among males and females. Only 12.2% of the total cases seen were severe. The case fatality rate was 2%. Local health policy should target timely interventions for biliary pancreatitis and should also address the local factors affecting disease severity. Highlights ? This is the first known epidemiological study on acute pancreatitis in the Caribbean and found a case fatality rate of 2%. ? This is the first report of a female preponderance in acute pancreatitis. ? Biliary pancreatitis was the predominant aetiology in both males and females. ? Transfer status, overweight/obesity, idiopathic aetiology and post-ERCP status increased duration of hospitalisation. ? Disease severity was mild in 61.1%, and severe in 12.2% of patients, with severe cases more likely to have an idiopathic aetiology, post-ERCP status and higher burden of overweight/obesity.