Risk factors for acute pancreatitis

Q; All of the following are risk factors for developing complications and worse prognosis in acute pancreatitis EXCEPT? - select one

A) Older age 

B) Male gender

C) Alcoholic pancreatitis 

D) Short time interval to symptom onset 

E) Obesity 

Answer: B

Gender doesn't play much role in predicting prognosis in acute pancreatitis.

One study showed that age above 75 years had more than a 15-fold greater chance of dying within two weeks and a more than 22-fold greater chance of dying within 91 days compared with patients aged 35 years or younger (reference # 1).

Alcoholic pancreatitis has higher chances of developing pancreatic necrosis and of buying a ventilator due to the development of ARDS.

Short time interval to symptom onset and hospital admission, particularly of less than 24 hours is associated with poor outcomes.

BMI >30 is also a risk factor.

On clinical exam, if there is rebound tenderness and/or guarding is present, severe pancreatitis and chances of complications should be suspected.

#GI

References:

1. Frey CF, Zhou H, Harvey DJ, White RH. The incidence and case-fatality rates of acute biliary, alcoholic, and idiopathic pancreatitis in California, 1994-2001. Pancreas 2006; 33:336.

2. Banks PA, Freeman ML, Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006; 101:2379.

3. Papachristou GI, Papachristou DJ, Morinville VD, et al. Chronic alcohol consumption is a major risk factor for pancreatic necrosis in acute pancreatitis. Am J Gastroenterol 2006; 101:2605.

4. Martínez J, Johnson CD, Sánchez-Payá J, et al. Obesity is a definitive risk factor of severity and mortality in acute pancreatitis: an updated meta-analysis. Pancreatology 2006; 6:206.