Severity and mortality of acute pancreatitis in Austria – a retrospective study

Introduction Acute pancreatitis is a frequent cause of hospitalization. Limited information is available on the mortality and severity in Austria.

Material and Methods Patients admitted with acute pancreatitis between 2018 and 2021 at two centers were included. Epidemiological, etiological, and outcome data were extracted retrospectively from electronic health care records.

Results Overall, 503 patients with a total of 569 cases were included. Median age was 61 (IQR 49.0;75.0) years, 55% (n=278) of patients were male, median length of stay was 7 days (IQR 4;12). The most common etiologies were biliary (38.3%), alcohol-associated (24.3%) and idiopathic (22.8%) pancreatitis. In total, 22.4% developed acute kidney injury, 6.2% had to be admitted to an ICU. Disease severity was mild in 59.9%, moderately-severe in 32.5%, and severe in 7.6% of cases. The median MODS score among severe cases was 4.0 (IQR 2.0;6.5). The 30-day, 90-day, and overall all-cause mortalities were 2.1%, 3.3%, and 5.6% respectively. Severe disease was found in 6.9% of biliary, 10.1% of alcoholic and 4.6% of idiopathic pancreatitis cases (p=0.21). Severe disease was significantly associated with hypocalcemia (p=0.044), hypertriglyceridemia (p=0.0001), and Charlson comorbidity index (CCI) (p=0.026), but not with age (p=0.127), BMI (p=0.811), or sex (p=0.87). Overall all-cause mortality in the mild, moderate and severe cohorts was 3.0%, 2.3%, and 37.2%.

Conclusion The majority of findings concerning disease mortality were consistent with international data. Interestingly, the distribution of severity was shifted more towards moderate and severe acute pancreatitis in comparison to literature of the past decades. However, more recent European studies of similar methodology and sample size published similar results, possibly indicating a general shift in severity distribution. Severe disease prevalence was not associated with most common etiologies, patient age, or sex.

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Artikel online veröffentlicht:
13. Mai 2025