Prognosis of Chronic Pancreatitis: An International Multicenter Study

Albert B. Lowenfels, Patrick Maisonneuve, Giorgio Cavallini, Rudolf W, Paul G. Lankisch, Jens R. Andersen, Eugene P. DiMagno, Åke Andrén‐Sandberg, Lennart Domellöf, Vincenzo Di Francesco, Paolo Pederzoli, Annette Lühr‐Happe, Einar Krag, Peter Boyle, C. S. Pitchumoni, Pe Shein Wynn, L. Joseph Melton

Research output: Contribution to journalArticlepeer-review

168 Scopus citations


Objectives: Tbe aim of this study was to determine which factors predict mortality in a cobort of patients with cbronic 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 mul‐tivariate 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
JournalThe American Journal of Gastroenterology
Issue number9
StatePublished - Sep 1994

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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