Journal of Pediatric Gastroenterology & Nutrition:
North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Annual Meeting, October 19-22, 2006, Orlando, Florida: Abstracts: ORAL ABSTRACT PRESENTATIONS: CLINIC SCIENCES SATURDAY, OCTOBER 21, 2006, 2:00 p.m. - 3colon;30 p.m.: 190
1Clinical Research, Tufts-New England Medical Center, Boston, MA; 2Pediatric Gastroenterology, Massachusetts General Hospital, Boston, MA.
Recent small studies suggest that acute pancreatitis (AP) in children is increasing in frequency and is associated with significant morbidity and mortality. No studies have examined AP in children using a large, nationwide database.
Determine national incidence and hospital case-fatality rates (CFR) of AP according to patient demographics, hospital characteristics, and time. Report potentially etiologic diagnoses associated with AP and identify prognostic factors associated with in-hospital death in children with AP.
This cross-sectional study of 7346 children <21 years of age with AP used nationwide data from the 1997 and 2000 U.S. Kids' Inpatient Databases. Etiologies were captured using an ICD-9-CM coding scheme, while prognostic factors associated with hospital death were identified using multivariable logistic regression.
National incidence rates of AP increased from 6.0 per 100,000 children in 1997 to 8.0 in 2000 (P < 0.001) with rates highest among older children, females and nonwhites. National hospital CFRs were similar at 2.1% in 1997 and 1.9% in 2000 with rates highest among younger children and males. Incidence rates and CFRs were higher at urban teaching and freestanding children's hospitals. The most common etiologic diagnosis associated with AP was biliary lithiasis. Lithiasis was four times more common in girls than in boys and potentially responsible for almost half of AP cases in adolescent females. Younger age, male gender, a secondary diagnosis of AP, chemotherapy infusion, bone marrow transplantation, and transfer to or treatment at larger, freestanding children's hospitals were associated with greater odds of dying during hospitalization.
Acute pancreatitis in children appears to be increasing in frequency, carries a significant risk of death, especially among males, the young and patients with cancer, and is more commonly associated with biliary lithiasis than previously reported.