Risk factors of mortality in painful chronic pancreatitis / 中华胰腺病杂志

ABSTRACT

Objective To investigate the survival of patients with painful chronic panereatitis and evaluate the risk factors for mortality in these patients.Methods This was a historical cohort study,subjects ≥18 yr with painful chronic pancreatitis who were treated in our center from Feb.1997 to July 2007 were enrolled.A life-table method was used to estimate the probability of the cumulative survival rate.COX proportional-hazards model was used for multivariate analysis.Results Follow-up data were obtained from 346 patients (87.2%) with the ratio of male/female was 2.41.The age of first admission and first symptom onset was (47±14)years and (43±15 ) years.The mean follow-up period was ( 34.3±27.1 ) months.Alcoholic origin accounted for 22.2% of all the patients,while biliary origin was 26.0%.The overall mortality rate was 9.8% (34/346),which happened (62.5±61.1 ) months after abdominal pain was present.The causes of mortality included pancreatic cancer and cancers of other sites.The cumulative survival rate estimated at 2 years was 96.3%,at 5 years 93.6% and at 10 years 86.4%.COX proportional-hazards model suggested age at onset (≥51 years),no improvement of abdominal pain or increased frequency of pain,active smoking,and no diarrhea were associated with increased mortality,and the corresponding hazard rates (HR) were 3.4,3.5,4.2,2.8 and 17.7,respectively.Conclusions The mortality rate of painful chronic panereatitis in China was lower than those reported outside China.The main cause of mortality was pancreatic cancer.Great caution shall be placed on patients with age at onset ≥51 yr,no improvement of abdominal pain,increased frequency of pain,active smoking and no diarrhea.