# Comparison of the Clinical Course, Management and Outcomes of Acute Pancreatitis in Aged and Young Patients

## TL;DR

This study compares how acute pancreatitis affects older and younger patients, highlighting differences in causes, symptoms, and outcomes.

## Contribution

The paper provides insights into age-related differences in acute pancreatitis management and outcomes, emphasizing personalized treatment for elderly patients.

## Key findings

- Elderly patients with acute pancreatitis have more comorbidities and higher mortality rates compared to younger patients.
- Biliary pancreatitis is more common in older adults, while alcohol-induced pancreatitis is more prevalent in younger individuals.
- Older patients often present with atypical symptoms and require personalized treatment approaches due to higher risks of complications.

## Abstract

Acute pancreatitis (AP) is an inflammatory condition with varying severity, ranging from mild self-limiting episodes to life-threatening complications. The incidence, clinical presentation, and outcomes of AP differ significantly across age groups, with elderly patients demonstrating distinct challenges. Biliary pancreatitis is more prevalent in older adults, whereas alcohol-induced AP dominates in younger populations. Elderly patients frequently present with atypical or less pronounced abdominal symptoms, which may delay diagnosis. Comorbidities such as kidney failure, cardiovascular disease, diabetes mellitus and arterial hypertension are significantly more common in the elderly and are associated with increased risk of organ dysfunction, systemic complications such as organ failure, multiple organ dysfunction syndrome (MODS), and prolonged hospitalization. The higher incidence of intensive care unit admissions and mortality is noted in the elderly, particularly in those over 80 years, in particular. Evidence on age-related differences in local pancreatic complications is inconsistent, with a possible trend toward lower rates in older adults. Early identification and individualized treatment planning are essential. Abundant fluid administration should be limited in older patients due to frequent cardiac insufficiency but should be carefully monitored due to the present or threatening renal insufficiency. Pain control with opioids may cause severe CNS complications for elderly patients. In contrast, ERCP, when indicated, is usually well tolerated in older patients. Personalized management in elderly patients is strongly recommended.