Prognosis of chronic pancreatitis: An international multicenter study

A. B. Lowenfels, P. Maisonneuve, G. Cavallini, R. W. Ammann, P. G. Lankisch, J. R. Andersen, E. P. DiMagno, A. Andren-Sandberg, L. Domellof, V. Di Francesco, P. Pederzoli, A. Lohr-Happe, E. Krag, P. Boyle, C. S. Pitchumoni, Shein Wynn Pe Shein Wynn, L. J. Melton

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Abstract

Objectives: The aim of this study was to determine which factors predict mortality in a cohort of patients with chronic alcoholic and nonalcoholic pancreatitis. Patients with chronic pancreatitis are known to have a reduced life expectancy, but the quantitative relationship between various clinical features and survival is unclear. Methods: We evaluated survival among 2015 subjects with chronic pancreatitis treated at seven centers located in six countries. Results: Mean age at diagnosis was 46 ± 13 yr and mean duration of follow-up was 7.4 ± 6.2 yr. Overall survival at 10 yr was 70% (95% confidence interval (CI), 68-73%) and at 20 yr was 45% (95% CI, 41-49%). Survival was significantly less than in the background population. There were 559 deaths observed among those with chronic pancreatitis compared with an expected number of 157.4, yielding a standardized mortality ratio (SMR) of 3.6 (95% CI, 3.3-3.9). Older subjects and those with alcoholic pancreatitis had a significant reduction in survival. In a multivariate analysis, mortality of middle-aged and older subjects was 2.3 (95% CI, 1.8-2.8) and 6.3 (95% CI, 4.7-8.3) times greater than subjects less than 40 yr at diagnosis. Smoking (hazard ratio, 1.4; 95% CI, 1.0-1.9), drinking (hazard ratio, 1.6; 95% CI, 1.2-2.2), or development of cirrhosis (hazard ratio, 2.5; 95% CI, 2.0-3.2) increased the risk of death during the observation period, but we observed no survival difference in operated vs. nonoperated patients. Conclusions: Age at diagnosis, smoking, and drinking are major predictors of mortality in patients with chronic pancreatitis.

Original languageEnglish (US)
Pages (from-to)1467-1471
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume89
Issue number9
StatePublished - 1994

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Chronic Pancreatitis
Multicenter Studies
Confidence Intervals
Survival
Alcoholic Pancreatitis
Mortality
Drinking
Smoking
Life Expectancy
Fibrosis
Multivariate Analysis
Observation
Population

ASJC Scopus subject areas

  • Gastroenterology

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Lowenfels, A. B., Maisonneuve, P., Cavallini, G., Ammann, R. W., Lankisch, P. G., Andersen, J. R., ... Melton, L. J. (1994). Prognosis of chronic pancreatitis: An international multicenter study. American Journal of Gastroenterology, 89(9), 1467-1471.

Prognosis of chronic pancreatitis : An international multicenter study. / Lowenfels, A. B.; Maisonneuve, P.; Cavallini, G.; Ammann, R. W.; Lankisch, P. G.; Andersen, J. R.; DiMagno, E. P.; Andren-Sandberg, A.; Domellof, L.; Di Francesco, V.; Pederzoli, P.; Lohr-Happe, A.; Krag, E.; Boyle, P.; Pitchumoni, C. S.; Pe Shein Wynn, Shein Wynn; Melton, L. J.

In: American Journal of Gastroenterology, Vol. 89, No. 9, 1994, p. 1467-1471.

Research output: Contribution to journalArticle

Lowenfels, AB, Maisonneuve, P, Cavallini, G, Ammann, RW, Lankisch, PG, Andersen, JR, DiMagno, EP, Andren-Sandberg, A, Domellof, L, Di Francesco, V, Pederzoli, P, Lohr-Happe, A, Krag, E, Boyle, P, Pitchumoni, CS, Pe Shein Wynn, SW & Melton, LJ 1994, 'Prognosis of chronic pancreatitis: An international multicenter study', American Journal of Gastroenterology, vol. 89, no. 9, pp. 1467-1471.
Lowenfels AB, Maisonneuve P, Cavallini G, Ammann RW, Lankisch PG, Andersen JR et al. Prognosis of chronic pancreatitis: An international multicenter study. American Journal of Gastroenterology. 1994;89(9):1467-1471.
Lowenfels, A. B. ; Maisonneuve, P. ; Cavallini, G. ; Ammann, R. W. ; Lankisch, P. G. ; Andersen, J. R. ; DiMagno, E. P. ; Andren-Sandberg, A. ; Domellof, L. ; Di Francesco, V. ; Pederzoli, P. ; Lohr-Happe, A. ; Krag, E. ; Boyle, P. ; Pitchumoni, C. S. ; Pe Shein Wynn, Shein Wynn ; Melton, L. J. / Prognosis of chronic pancreatitis : An international multicenter study. In: American Journal of Gastroenterology. 1994 ; Vol. 89, No. 9. pp. 1467-1471.
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abstract = "Objectives: The aim of this study was to determine which factors predict mortality in a cohort of patients with chronic alcoholic and nonalcoholic pancreatitis. Patients with chronic pancreatitis are known to have a reduced life expectancy, but the quantitative relationship between various clinical features and survival is unclear. Methods: We evaluated survival among 2015 subjects with chronic pancreatitis treated at seven centers located in six countries. Results: Mean age at diagnosis was 46 ± 13 yr and mean duration of follow-up was 7.4 ± 6.2 yr. Overall survival at 10 yr was 70{\%} (95{\%} confidence interval (CI), 68-73{\%}) and at 20 yr was 45{\%} (95{\%} CI, 41-49{\%}). Survival was significantly less than in the background population. There were 559 deaths observed among those with chronic pancreatitis compared with an expected number of 157.4, yielding a standardized mortality ratio (SMR) of 3.6 (95{\%} CI, 3.3-3.9). Older subjects and those with alcoholic pancreatitis had a significant reduction in survival. In a multivariate analysis, mortality of middle-aged and older subjects was 2.3 (95{\%} CI, 1.8-2.8) and 6.3 (95{\%} CI, 4.7-8.3) times greater than subjects less than 40 yr at diagnosis. Smoking (hazard ratio, 1.4; 95{\%} CI, 1.0-1.9), drinking (hazard ratio, 1.6; 95{\%} CI, 1.2-2.2), or development of cirrhosis (hazard ratio, 2.5; 95{\%} CI, 2.0-3.2) increased the risk of death during the observation period, but we observed no survival difference in operated vs. nonoperated patients. Conclusions: Age at diagnosis, smoking, and drinking are major predictors of mortality in patients with chronic pancreatitis.",
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T2 - An international multicenter study

AU - Lowenfels, A. B.

AU - Maisonneuve, P.

AU - Cavallini, G.

AU - Ammann, R. W.

AU - Lankisch, P. G.

AU - Andersen, J. R.

AU - DiMagno, E. P.

AU - Andren-Sandberg, A.

AU - Domellof, L.

AU - Di Francesco, V.

AU - Pederzoli, P.

AU - Lohr-Happe, A.

AU - Krag, E.

AU - Boyle, P.

AU - Pitchumoni, C. S.

AU - Pe Shein Wynn, Shein Wynn

AU - Melton, L. J.

PY - 1994

Y1 - 1994

N2 - Objectives: The aim of this study was to determine which factors predict mortality in a cohort of patients with chronic alcoholic and nonalcoholic pancreatitis. Patients with chronic pancreatitis are known to have a reduced life expectancy, but the quantitative relationship between various clinical features and survival is unclear. Methods: We evaluated survival among 2015 subjects with chronic pancreatitis treated at seven centers located in six countries. Results: Mean age at diagnosis was 46 ± 13 yr and mean duration of follow-up was 7.4 ± 6.2 yr. Overall survival at 10 yr was 70% (95% confidence interval (CI), 68-73%) and at 20 yr was 45% (95% CI, 41-49%). Survival was significantly less than in the background population. There were 559 deaths observed among those with chronic pancreatitis compared with an expected number of 157.4, yielding a standardized mortality ratio (SMR) of 3.6 (95% CI, 3.3-3.9). Older subjects and those with alcoholic pancreatitis had a significant reduction in survival. In a multivariate analysis, mortality of middle-aged and older subjects was 2.3 (95% CI, 1.8-2.8) and 6.3 (95% CI, 4.7-8.3) times greater than subjects less than 40 yr at diagnosis. Smoking (hazard ratio, 1.4; 95% CI, 1.0-1.9), drinking (hazard ratio, 1.6; 95% CI, 1.2-2.2), or development of cirrhosis (hazard ratio, 2.5; 95% CI, 2.0-3.2) increased the risk of death during the observation period, but we observed no survival difference in operated vs. nonoperated patients. Conclusions: Age at diagnosis, smoking, and drinking are major predictors of mortality in patients with chronic pancreatitis.

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