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Case-Fatality from Acute Pancreatitis is Decreasing but its Population Mortality Shows Little Change

Writer: Tony VinesTony Vines

Logo for the National Institutes of Health

Date:

2016 Jul-Aug;16

PMID:

Category:

2

Authors:

Satish Munigala 1, Dhiraj Yadav 2

Abstract:

Background/Objectives: The reasons for changing epidemiology of acute pancreatitis (AP) are poorly defined. We hypothesized that trends for severity, case-fatality and population mortality from AP will provide an insight into the rising burden of AP in the population. We evaluated trends in the hospitalizations, case-fatality, severity and population mortality related to AP in the US population.


Study: We used the National Hospital Discharge Survey to calculate age, sex and race standardized hospitalizations of and case-fatality rates for AP, and Vital Statistics to calculate AP-related population mortality from 1983 to 2010, using 2010 US census as the reference.


Results: Number of discharges per 100,000 population with primary diagnosis of AP increased 2 times from 42.4 (95% CI 38.2-46.5) during 1983-1986 to 85.4 (95% CI 62.8-108.1) during 2007-2010. During corresponding intervals, case-fatality from AP decreased 62% from 2.02% (95% CI 2.01-2.04) to 0.79% (95% CI 0.78-0.80), but population mortality per million population due to AP as primary cause remained stable from 9.28 (95% CI 8.94-9.62) to 9.91 (95% CI 9.56-10.26), and from AP as any cause decreased significantly (but only 12%) from 20.87 (95% CI 20.36-21.38) to 18.48 (95% CI 18.00-18.96). Prevalence of severe AP increased from 5% (95% CI 4.95-5.05%) during 1991-1994 to 9.78% (95% CI 9.73-9.83%) during 2007-2010.


Conclusion: An increasing prevalence of severe disease suggests true population increase to be an important contributor to the rising incidence of AP. A lack of proportional increase in population mortality suggests the impact of medical advances in the evaluation and management of AP.


Copyright © 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.


 

Acknowledgements:

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, the National Institute of Health, or the National Institute of Diabetes and Digestive and Kidney Diseases.


The Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC) Research Consortia is supported and funded by grants from the National Cancer Institute and the National Institute of Diabetes and Digestive and Kidney Diseases under the following award numbers:

Project Number:

Awardee Organization

U01DK108326

Baylor College of Medicine

U01DK108314

Cedars-Sinai Medical Center

U01DK108332

 Indiana University

U01DK108323

Kaiser Foundation Research Institute

U01DK108288

Mayo Clinic

U01DK108327

Ohio State University

U01DK108300

Stanford University

U01DK108320

University of Florida

U01DK108306

University of Pittsburgh

U01DK108328

University of Texas MD Anderson Cancer Center


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