Validation Of Chronic Pancreatitis Prognosis Score (COPPS) in a Tropical Cohort of Chronic Pancreatitis

INTRODUCTION Chronic pancreatitis is an inflammatory disease of the pancreas characterized by abdominal pain, repeated episodes of acute pancreatitis, and fibrotic destruction of the organ, resulting in exocrine and endocrine insufficiency. During the last decade, several reports have provided evidence that repeated attacks of acute pancreatitis may progress to chronic pancreatitis [1].

The disease may present clinically either with an individual symptom or a combination of symptoms associated with loss of pancreatic function. The natural history of chronic pancreatitis is usually characterized by progression of tissue damage and various degrees of exocrine and endocrine pancreatic insufficiency, which will become apparent over time, independent of the underlying etiology, chronic pancreatitis evolves toward the same end stage, i.e., pancreatic fibrosis [2].

The prevalence of CP has been approximated at ~50/100,000 population [3]. The underlying etiologies are multifactorial and among many involve excessive alcohol consumption, smoking, genetic predisposition and autoimmune pancreatitis.

It is general knowledge that the terminal stage of chronic pancreatitis results in a loss of organ function, with the clinical manifestations of maldigestion and diabetes mellitus. However, there is little knowledge of the early structural and functional abnormalities because the current diagnostic imaging procedures are not sensitive enough to visualize them and histology is normally not available in these early stages [4].

Abdominal pain is the most frequent symptom of CP. However, the severity, temporal nature, and natural history of pain is highly variable [5].