Re: Life expectancy for those with chronic pancreatitis

August 31, 2002

Expected results

A number of systems have been developed to help determine the

prognosis of an individual with pancreatitis. A very basic evaluation

of a patient will allow some prediction to be made based on the

presence of dying pancreatic tissue (necrosis) and bleeding. When

necrosis and bleeding are present, as many as 50% of patients may die.

More elaborate systems have been created to help determine the

prognosis of patients with pancreatitis. Ranson's signs, the most

commonly used system, identifies 11 different signs that can be used

to determine the severity of the disease. The first five categories

are evaluated when the patient is admitted to the hospital:

age over 55 years

blood sugar level over 200 mg/Dl

serum lactic dehydrogenase over 350 IU/L (increased with increased

breakdown of blood, as would occur with internal bleeding, and with

heart or liver damage)

AST over 250 µ (a measure of liver function, as well as a gauge of

damage to the heart, muscle, brain, and kidney)

white blood count over 16,000 µL

The next six of Ranson's signs are reviewed 48 hours after admission

to the hospital. These are:

greater than 10% decrease in hematocrit (a measure of red blood cell

volume)

increase in BUN (blood urea nitrogen, an indicator of kidney

function) greater than 5 mg/dL

blood calcium less than 8 mg/dL

PaO2 (a measure of oxygen in the blood) less than 60 mm Hg

base deficit greater than 4 mEg/L (a measure of change in the normal

acidity of the blood)

fluid sequestration greater than 6 L (an estimation of the quantity

of fluid that has leaked out of the blood circulation and into other

body spaces).

Once a doctor determines how many of Ranson's signs are present and

gives the patient a score, the doctor can better predict the risk of

death. The more signs present, the greater the chance of death. A

patient with less than three positive Ranson's signs has a less than

5% chance of dying. A patient with three to four positive Ranson's

signs has a 15-20% chance of dying.

The results of a CT scan can also be used to predict the severity of

pancreatitis. Slight swelling of the pancreas indicates mild illness.

Significant swelling, especially with evidence of destruction of the

pancreas and/or fluid buildup in the abdominal cavity, indicates more

severe illness. With severe illness, there is a worse prognosis.

From:

http://www.findarticles.com/cf_dls/g2603/0005/2603000573/p6/article.jh

tml?term=

, we are out to rewrite the history here. A lot of great

things are now being done. A lot more are to come! I am donating my

body in the name of research of pancreatitis. I carry the card. We

will try our best to not let you down. Calm down and enjoy LABOR DAY!

Sis and Hub will have to take it as it comes. Right now they stand a

worse chance, against a drunk driver! Becareful out there this long

weekend.

> I know I have already asked some questions. I have read some of the

> past messages and have heard some talk about pancreatitis as being

> deadly. Does chronic pancreatitis result in death in most patients?

> If pancreatectomies are performed can a person live a long time

with

> insulin replacement? Maybe I am getting ahead of myself here, but I

> am worried sick about my sister. I feel bad for all of you who have

> to suffer with this terrible disease and it is shocking so little

is

> known and so little really helps with it. I hate to say I am

> consumed by all this right now, but if the diagnosis is truly

> chronic I am worried how she and her hubby will deal with this.

>

August 31, 2002

- I have read some of the

> past messages and have heard some talk about pancreatitis

as being deadly. Does chronic pancreatitis result in death in

most patients?

Maybe I am getting ahead of myself here, but I am worried sick

about my sister. I I hate to say I am consumed by all this right

now, but if the diagnosis is truly chronic I am worried how she

and her hubby will deal with this.

>

,

I can understand your fear for your sister, yet you need to put your

mind at rest. Although chronic pancreatitis is a major

adjustment for people to deal with, it very likely will NOT be the

cause of most of our deaths. Something else will be, like old

age, other medical complications, a car wreck, or something that

happens to anyone. I do not consider this disease to be of any

threat to my life, it just makes things harder to deal with. It is very

hard to even find statistics to support a mortality rate for chronic

pancreatitis alone. This is a statement made by the National

Pancreas Foundation:

Pancreatitis is an inflammatory condition of the pancreas that is

painful and at times deadly. Despite the great advances in

critical care medicine over the past 20 years, the mortality rate of

acute pancreatitis has remained at about 10%.

This quote is talking about acute pancreatitis, not chronic. And it

is talking about situations where the acute condition caused

organ failure and a multitude of other medical problems. Most

other articles I researched spoke only of the complications that

could develop during attacks of acute pancreatitis, and most

said the mortality rate was less than 5%. Conditions of chronic

pancreatitis carried a higher mortality risk only for those with

pseudocysts or tumors in additon to their chronic pancreatitis

(7%), yet even then I could find few facts supporting any actual

mortality rates.

Some of our members have had this condition since birth, and

some were first diagnosed well over 20 years ago, and I think all

have expectations of living a long, long time. I think you need to

stop dwelling on this. The things that will help your sister best is

a good specializing physician, a good diet and proper treatment

of her condition.

With hope and prayers,

Heidi

Heidi H. Griffeth

South Carolina

hhessgriffeth@...

Southeastern Representative

Pancreatitis Association, Intl.

http://www.pancassociation.org/storieshome.html#Heidi

August 31, 2002