PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK
Authors:   PANC Study Collaborative, Kosti Angeliki , Borakati Aditya , Varma Aarti , Gupta Aayush , Mustafa Abdalla , Hakeem Abdul , Quddus Abdul , Sahl Abdullah Bin , Beniwal Abhijeet , Adesuyi Abidemi , Krzak Ada Maria , Brooks Adam , Frampton Adam , Gadhvi Adam , Talbot Adam , Elnogoomi Ahmed , Mahgoub Ahmed , Naqvi Ahmed , Pervez Ahmed , Bodla Ahmed Salman , Taha Ahmed , Tawfik Ahmed , Prabhu Aishwarya , Puri Aiysha , Belgaumkar Ajay , Gupta Ajay , McCrorie Alan , Findlay Alasdair , Healey Albert , De Prendergast Alexandra , Farrugia Alexia , Dosis Alexios , Adiamah Alfie , Sallam Ali , Wong Alicia , Bradley Alison , Martin Allie , Collins Alma , Awan Altaf , Bond Amanda , Koh Amanda , Kourdouli Amar , Patel Ameet G , Dhannoon Amenah , Khalil Amjad , Banerjee Amlan , Khan Amnah , Elserafy Amr , Alamassi Amro , Owen Amy , Benjafield Anastasia , Zuccarrelli Andrea , Luhmann Andreas , Jones Andrew , Kennedy-Dalby Andrew , Smith Andrew M , Kaul Anil , Kumar Anil , White Annabelle , Baker Annalie , Minicozzi Annamaria , Bardoli Antonio , Golpe Antonio Leyte , Manzelli Antonio , Sivakumar Aran , Saha Arin , Shajpal Arjun , Lango Artemisia , Cotton Arthur , Nair Ashitha , Brown Ashley , Menon Ashok , Tandon Ashutosh , Afza Asma , Hassan Asma , Shamali Awad , Khalid Ayesha , Regan Azel , Piramanayagam Balasubramanian , Oyewole Bankole , Ibrahim Basil , Murphy Ben , Clayton Bethan , Jenkins Bethan , Kumar Bhaskar , Rybinski Blazej , Khor Bo Yuan , Davidson Brian R , Lees Bryony , Blacklock Callum , Johnstone Callum , Salinas Camila Hidalgo , Boven Carine , Wolstenholme Caroline , Chin Carven , Gilmore Catherine , Sharp Catherine , Walker Cerys , Harris Chad , Khanna Chaitra , Ferguson Chanoka , Kyriakides Charis , Bee Charlotte , Currow Chelise , Parmar Chetan , Collins Chris , Halloran Christopher , Smart Chris J , Neophytou Christodoulos , Delaney Christopher , Anele Chukwuemeka , Heugh Claire , Choh Clarisa Thian Puay , Kenington Cleo , Wyatt Craig , Borg Cynthia-Michelle , Mole Damian , Arumugam Danaradja , Gunia Dariusz , Porter Darren , Berry David , Griffith David , Hou David , Longbotham David , Mitton David , Strachan David , Di Mauro Davide , Worku Dawit , Heaphy Deborah , Dunne Declan , Yeung Denise , Arambepola Devika , Leswas Dhya Al , Pournaras Dimitri J , Damaskos Dimitrios , Saleh Dina , Osilli Dixon , Pearman Douglas , Whitelaw Douglas , Haq Ehsan Ul , Mack Eleanor , Spurring Eleanor , Jamieson Elias , Lenzi Elisa , Gemmill Elizabeth , Gammeri Emanuele , Bota Emil , Britton Emily , Farrow Emily , Lloyd Emily , Moran Emily , Itobi Emmanuel , Craig Eoin , Tanaka Ermal , Chohda Ezzat , Muhammad Fahad Ullah , Youssef Fahed , Roslan Farah , Amir Farhat , Froghi Farid , Di Franco Filippo , Abbadessa Francesco , DiMaggio Francesco , Gurung Ganga , Faulkner Gemma , Choa George , Kerans George , Davis George N , Galanopoulos Georgios , Karagiannidis Georgios , McCabe Gerard , Mohammadi-Zaniani Ghazaleh , Nawaz Ghulam , Van Boxel Gijs , Bond-Smith Giles , Tierney Gillian M , Muthukumarasamy Girivasan , Grey Grace , Wong Grace , Finch Guy , Khan Hamad , Bourne Hannah , Javanmard-Emamghissi Hannah , Murray Hannah , Rottenburg Hannah , Wright Hannah , Khalil Hany , Spiers Harry V M , Bashiti Hazem , Shanti Hiba , Ebied Husam , Ng Hwei Jene , Hamid Hytham K S , Kim Hyun , Wilson Iain , Rajendran Ilayaraja , Gerogiannis Ioannis , Patel Ishaan , El-Abbassy Islam , Burridge Isobel , Caldwll Jade , Jackman Jamaall , Clark James , Duncan James , Milburn James , O’Kelly James , Olivier James , Rink James , Royle James , Rai Jason , Latif Javed , Ahmad Jawad , Maliyil Jed , Carr Jenna , Coles Jennifer , McGarry Jennifer , Apollos Jeyakumar , Lim Jie , Gray Joanna , Thomas Joel , Bennett John , Findlay John , Spearman John , Young John , Lund Jonathan N , Meilak Joseph , Alfred Joshua , Welsh Joshua , Chan Juen Hao , Martin Julia , Patel Kamlesh , Ko Kar Yeung Kenneth , Isand Karl , Razi Kasra , Sarathy Kasturi , Powezka Katarzyna , Foster Kate , Peleki Katerina , Bevan Katharine , Fox Katherine , Edwards Katie , Larsen Katy , Spellar Kayleigh , Oh Ke En , Kong Keh , Brown Keiran , Roberts Keith J , Seymour Keith , Beatson Kevin , Etherson Kevin , Willis Kevin , Mann Kulbir , Nizami Kulsoom , Rajput Kunal , Lavery Lauren , Sawdon Lauren , Nip Lawrence , Al-Hamed Layal , Fagan Leah , Watton Leo , Saint-Grant Alexander Les , Convie Liam , Girard Louis-Pierre , Huppler Lucy , Marsh Luke , Seretny Luke , Newton Lydia , Buksh Mahfooz , Sallam Mahmoud , Mathew Malayil , Prasanth Manju Nadh , Nayar Manu , Wijeyaratne Manuk , Hollyman Marianne , Ransome Marina , Popa Mariuca , Galea Mark , Taylor Mark , Gismondi Martha , Michel Martin , Wadley Martin , Al-Azzawi Marwa , Claxton Mary , Kuzman Matta , Bonomaully Matthew , Newman Matthew , Bhandari Mayank , Courtney Michael , Jones Michael , Rarity Michael , Wilson Michael , Ebraheem Mohamed , Elnaghi Mohamed , Mohamed Mohamed Saleem Noor , Al-Hijaji Mohammed , Al-Rashedy Mohammed , Qayum Mohammed Kaif , Zourob Mohammed , Gaber Mohannad , Rao Milind , Islam Muhammad Ariful , Rashid Muhammad Umair , Zafar Muneeb , Naqvi Mushal , Ahmad Mustafa Nabeel , Telfah Muwaffaq , Merali Nabeel , Hanbali Nabih , Gulnaz Nadia , Kumar Nagappan , Husain Najam , Angamuthu Natarajan , Murali Navanith , Kirmani Naveed , Assaf Nazrin , Doshi Neel , Shah Nehal Sureshkumar , Basra Nersheranjeet , Menezes Neville , Dai Nick , Schuijtvlot Nicolaas , Kansal Nisheeth , Chidumije Nnaemeka , Yassin Nuha , Babalola Olaitan , Oyende Olamide , Williams Olatoyosi , Pawlik Olga , O'Connor Olivia , Jalil Omar Abdel , Ryska Ondrej , Vaz Osborne , Sarmah Panchali , Jayawardena Panduka , Patel Panna , Hart Patrick , Cromwell Paul , Manby Paul , Marriott Paul , Needham Paul , Ghaneh Paula , Rao Pawan Kumar Dhruva , Eves Peter , Coe Peter O , May-Miller Peter , Szatmary Peter , Ireland Philip , Seta Pooja , Ravi Prabhu , Janardhanan Pradeep , Patil Pradeep , Mistry Pritesh , Heer Priya , Patel Puja , Nunes Quentin , Ain Quratul , Clifford Rachael , Brindle Rachel , Lee Rachel Xue Ning , Lim Rachel Qian Hui , Rahman Rafid , Kumar Rahul Mohan , Lunevicius Raimundas , Mukherjee Rajarshi , Lahiri Rajiv , Behmida Rami , Rajebhosale Ramprasad , Levy Raphael , Chhabra Raunaq , Oliphant Raymond , Freeman Rebecca , Jones Rebecca M , Elkalbash Rema , Brignall Rhiannon , Bell Richard , Byrom Richard , Laing Richard W , Patel Rikhilroy , Buhain Robert , Clark Robert , Sutton Robert , Presa Roberto , Lawther Roger , Patel Roshni , Zakeri Roxanna , Mashar Ruchir , Wei Rui , Baron Ryan , Tasleem Sadia , Kadambot Safwan Shafeeque , Azam Saima , Wajed Saj , Ali Sakhawat , Body Samantha , Saeed Samerah , Bandyopadhyay Samik , Mohamed Samy , Pandanaboyana Sanjay , Hassasing Sapna , Dyer Sarah , Small Sarah , Seeralakandapalan Sarangan , Arumugam Sathyaseelan , Chakravartty Saurav , Ong Seok Ling , Ooi Setthasorn Zhi Yang , Nazir Shahani , Zafar Shahbaz , Shirazi Shahram , Bharucha Shameena , Majid Shaukat , Ahmed Shehzad , Rajamanickam Shenbaga Kumar , Albalkiny Sherif , Ng Sherwin , Chowdhury Shihab , Yahia Shuker , Handa Siddhartha , Fallis Simon , Fisher Simon , Jones Simon , Phillips Simon , Mitra Smrthi , Aroori Somaiah , Thanki Sonam , Rozwadowski Sophie , Tucker Sophie , Conroy Soraya , Barman Sowrav , Bhat Srushti , McCallion Stephen , Knight Stephen R , Tezas Stergios , van Laarhoven Stijn , Cowie Stuart , Rao Sudhi , Sellahewa Sujeewa , Bhatti Sumbal , Kaistha Sumesh , Moug Susan J , Argyropoulos Susannah , Virupaksha Suvi , Difford Tabitha , Shikh-Bahaei Tamanna , Saafan Tamer , Lo Tammy , Magro Tania , Gala Tanzeela , Katbeh Tarek , Athwal Tejinderjit , Lo Terence , Fraser Tessa , Anyomih Theophilus , Chase Thomas J G , Walker Thomas , Ward Thomas , Gallagher Tom K , Richardson Tom , Wiggins Tom , Ali Uzair , Patnam Varun , Kanakala Venkatesh , Beynon Victoria , Hudson Victoria E , Morrison-Jones Victoria , Korwar Vijay , Massella Virginia , Parekh Vishal , Ng Vivian , Toh Wei Hann , Toh Wei , Hawkins William , Cambridge William , Harrison William , Tan Yan Yu , Aal Yasser Abdul , Malam Yogeshkumar , Toumi Zaher , Khaddar Ziad Al , Bleything Zoe 
Published: May 2023

Abstract

Background
Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment.

Methods
All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals.

Results
A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death.

Conclusion
Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions.