Increasing United States Hospital Admissions for Acute Pancreatitis, 1988–2003

Fagenholz, Peter J.; Castillo, C. Fernandez-del; Harris, N. Stuart; Pelletier, Andrea J.; Camargo, Carlos A.

doi:10.1016/j.annepidem.2007.02.002

Cited by 308 publications

(215 citation statements)

References 26 publications

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“…Population-based studies[5,6,14] indicate an increasing incidence with time, particularly for women. In the present 16-year audit, incidence increased slightly but significantly for women but not for men.…”

Section: Discussionmentioning

confidence: 99%

“…Population-based studies suggest an increasing trend for incidence of first attack acute pancreatitis (FAAP)[5,6] although it is unclear to what extent this might reflect changes in population age. The presumption that old age is a risk factor for mortality[5,7] is based upon case fatality rate (CFR), which does not take into account mortality in the background population.…”

Section: Introductionmentioning

confidence: 99%

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First attack of acute pancreatitis in Sweden 1988 – 2003: incidence, aetiological classification, procedures and mortality – a register study

et al. 2009

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BackgroundPopulation-based studies suggest that the incidence of first attack of acute pancreatitis (FAAP) is increasing and that old age is associated with increased mortality. Beacuse nationwide data are limited and information on standardized mortality ratio (SMR) versus age is lacking, we wanted to describe incidence and mortality of first attack acute pancreatitis (FAAP) in Sweden.MethodsHospital discharge data concerning diagnoses and surgical procedures and death certificate data were linked for patients with FAAP in Sweden. Mortality was calculated as case fatality rate (CFR), i.e. deaths per 1000 patients and SMR using age-, gender- and calendar year-specific expected survival estimates, and is given as mean with 95% confidence intervals. Data are presented as median values with 25% and 75% percentiles, means and standard deviations, or proportions. Proportions have been compared using the chi square test, Poisson-regression test or Fisher exact test. Location of two groups of ratio scale variables were compared using independent samples t-test or Mann-Whitney U-test.ResultsFrom 1988 through 2003, 43415 patients (23801 men and 19614 women) were admitted for FAAP. Age adjusted incidence rose from 27.0 to 32.0 per 100000 individuals and year. Incidence increased with age for both men and women. At index stay 19.7% of men and 35.4% of women had biliary diagnoses, and 7.1% of men and 2.1% of women alcohol-related diagnoses. Of 10072 patients who underwent cholecystectomy, 7521 (74.7%) did so after index stay within the audit period. With increasing age CFR increased and SMR decreased. For the whole period studied SMR was 11.75 (11.34–12.17) within 90 days of index admission and 2.03 (1.93–2.13) from 91 to 365 days. Alcohol-related diagnoses and young age was associated with increased SMR. Length of stay and SMR decreased significantly during the audit period.ConclusionIncidence of FAAP increased slightly from 1988 to 2003. Incidence increased and SMR declined with increasing patient age. Although the prognosis for patients with FAAP has improved it remains an important health problem. Aetiological classification at index stay and timing of cholecystectomy should be improved.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

First attack of acute pancreatitis in Sweden 1988 – 2003: incidence, aetiological classification, procedures and mortality – a register study

et al. 2009

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“…Over the last four decades, the overall incidence of acute pancreatitis seems to be increasing, not only in the United States, but also in different European countries: England,Scotland,Denmark,Sweden, Finland,Germany and the Netherlands [1,[3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Etiology of acute pancreatitis

2014

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AbstractAcute pancreatitis is a common disease with a benign course in the majority of patients, but it is associated with serious morbidity, and mortality close to 20% in up to 20% of cases. The incidence of acute pancreatitis seems to be rising in western countries. About 75% of all cases are caused by gallstones or alcoholism. The relative rate of gallstones versus alcohol as etiology depends on the age and the area of enrolment. A thorough evaluation allows cause identification in another 10% of cases, leaving about 15–20% as idiopathic. The most common causes, and a growing list of less frequent and sometimes very rare and controversial etiologies, are reviewed in this article. A classification on the pathogenic mechanisms of causes of acute pancreatitis based is used in this Review. The approach, or suggested plan of investigations, to determine the etiology of acute pancreatitis, based on the most recently published Guidelines is outlined.

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“…Most patients with AP have a mild disease that resolves spontaneously without sequelae, however, 10%-20% of patients experience a severe attack with high mortality up to 30% [1,2] . This high risk group of patients may benefit from aggressive fluid resuscitation, close monitoring for development of organ failure, proper administration of antibiotics and specific therapeutic procedures, such as endoscopic sphincterotomy and radiologic intervention [3] .…”

Section: Introductionmentioning

confidence: 99%