Epidemiology of Acute Pancreatitis in Hospitalized Children in the United States from 2000–2009

Abstract

BackgroundSingle-center studies suggest an increasing incidence of acute pancreatitis (AP) in children. Our specific aims were to (i) estimate the recent secular trends, (ii) assess the disease burden, and (iii) define the demographics and comorbid conditions of AP in hospitalized children within the United States.MethodsWe used the Healthcare Cost and Utilization Project Kids’ Inpatient Database, Agency for Healthcare Research and Quality for the years 2000 to 2009. Extracted data were weighted to generate national-level estimates. We used the Cochrane-Armitage test to analyze trends; cohort-matching to evaluate the association of AP and in-hospital mortality, length of stay, and charges; and multivariable logistic regression to test the association of AP and demographics and comorbid conditions.ResultsWe identified 55,012 cases of AP in hospitalized children (1–20 years of age). The incidence of AP increased from 23.1 to 34.9 (cases per 10,000 hospitalizations per year; P<0.001) and for all-diagnoses 38.7 to 61.1 (P<0.001). There was an increasing trend in the incidence of both primary and all-diagnoses of AP (P<0.001). In-hospital mortality decreased (13.1 to 7.6 per 1,000 cases, P<0.001), median length of stay decreased (5 to 4 days, P<0.001), and median charges increased ($14,956 to $22,663, P<0.001). Children with AP compared to those without the disease had lower in-hospital mortality (adjusted odds ratio, aOR 0.86, 95% CI, 0.78–0.95), longer lengths of stay (aOR 2.42, 95% CI, 2.40–2.46), and higher charges (aOR 1.62, 95% CI, 1.59–1.65). AP was more likely to occur in children older than 5 years of age (aORs 2.81 to 5.25 for each 5-year age interval). Hepatobiliary disease was the comorbid condition with the greatest association with AP.ConclusionsThese results demonstrate a rising incidence of AP in hospitalized children. Despite improvements in mortality and length of stay, hospitalized children with AP have significant morbidity.

EPC/HPSG evidence-based guidelines for the management of pediatric pancreatitis

“…Other studies found the incidence of multiple organ failure and pancreatic necrosis to be under 10% 32,106 , while the incidence of pseudocysts ranged 10-38% 32,106 . The mortality was 2-11%, mostly associated with systemic diseases 107,108 .…”

Analysis of Pediatric Pancreatitis (APPLE Trial): Pre-Study Protocol of a Multinational Prospective Clinical Trial

“…In the past few years, studies have showed an increased number of AP in children [1,2,3,4,5,6,7,8]. Based on the latest epidemiology report, there were over 50,000 new cases in the United States from 2000 to 2009 [7].…”

Clostridium difficile Infection in Hospitalized Patients with Cystic Fibrosis

“…Cohort matching was performed as described elsewhere with propensity scores and a greedy matching algorithm in a 1 : 5 matching ratio (CF and without CF). 5 The x 2 test, Mann-Whitney U test, and Cochrane Armitage test for trend and regression modeling were applied appropriately. CDI incidence among hospitalized patients 18-44 years of age with CF increased 0.9% to 1.6% from 2002 to 2010.…”