The Clinical Characteristics and Outcomes of Acute Pancreatitis Are Different in Elderly Patients: A Single-Center Study over a 6-Year Period

<b>Objectives:</b> This study aims to analyze the clinical characteristics of elderly patients with acute pancreatitis (AP) and investigate the effects of age on the clinical outcomes of AP. <b>Methods:</b> Patients aged ≥ 18 years with AP admitted within 72 h from 1 September 2013 to 31 August 2019 were included. Patients were divided into elderly (≥60 years) and non-elderly (<60 years) groups. Clinical data and outcomes were compared. <b>Results:</b> A total of 756 elderly and 4896 non-elderly patients with AP were included. The elderly patients had different etiological distributions and more severe clinical markers and scores. Age was an independent risk factor for mortality [odds ratio (OR): 2.911, 95% CI: 1.801-4.706, <i>p</i> < 0.001], intensive care unit admission (OR: 1.739, 95% CI: 1.126-2.685, <i>p</i> = 0.013), persistent organ failure (OR: 1.623, 95% CI: 1.326-1.987, <i>p</i> < 0.001), multiple organ failure (OR: 1.757, 95% CI: 1.186-2.604, <i>p</i> = 0.005), and infection (OR: 2.451, 95% CI: 1.994-3.013, <i>p</i> < 0.001). Adjusted multiple logistic regression and trend analysis confirmed the risk of the age for the outcomes. The deaths of elderly patients showed a biphasic pattern with peaks in the first and fifth weeks, in contrast to the single peak in the first week in the non-elderly patients. <b>Conclusions:</b> Elderly patients with AP were associated with worse clinical outcomes. It is crucial to devote considerable attention to the optimization of therapeutic approaches to reduce late mortality in this group of patients.