Etiology, Clinical Features, and Treatment Outcomes of Patients with Acute Pancreatitis: A 5-Year Experience at the Philippine General Hospital

Tristan Paulo Madrigal, MD; Aldrich Ivan Lois Burog, MD; Emilio Villanueva III, MD; Eric Yasay, MD
University of the Philippines - Philippine General Hospital

Significance: The global incidence of acute pancreatitis has increased over the past decade, but data in the Philippines remain limited, with the latest local study conducted before the Atlanta classification.

Methodology: A retrospective cohort study was conducted at a tertiary hospital in the Philippines, involving adult patients with acute pancreatitis admitted from January 2019 to December 2023. The primary outcome was in-hospital mortality, with secondary outcomes including predictors of mortality, organ failure, and underlying etiologies. A minimum sample size of 385 participants was computed.

Results: In total, 409 patients were included in the study, with a mean age of 47.35 ± 16.29 years and 48.17% being males. The severity of acute pancreatitis was mild in 60.9%, moderately severe in 10.2%, and severe in 28.9%. The most common etiology was gallstone (67.96%) followed by alcohol (23.23%) and infections (4.89%). The in-hospital mortality rate was 13.2%, rising to 35.15% for necrotizing pancreatitis. Renal failure was the most common organ involvement at 26.16%. Multivariate analysis identified older age (OR: 1.04), alcohol etiology (OR: 2.48), necrotizing subtype (OR: 4.00), higher Modified Marshall score (OR: 1.26), longer duration of symptoms before presentation (OR: 1.27), and lower serum albumin levels (OR: 0.46) as predictors of mortality.

Conclusion: Acute pancreatitis is associated with significant morbidity and mortality, particularly in patients with severe disease. Gallstone disease is the most common identified etiology, followed by alcohol and infections. Utilizing clinical predictors may identify patients who require aggressive resuscitation to reduce the risk of death.

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