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The Changing Epidemiology of Acute Pancreatitis Hospitalizations: A Decade of Trends and the Impact of Chronic Pancreatitis

Krishna, Somashekar G. MD, MPH; Kamboj, Amrit K. MD; Hart, Phil A. MD; Hinton, Alice PhD; Conwell, Darwin L. MD, MS

doi: 10.1097/MPA.0000000000000783
Original Articles

Objectives: The epidemiological trends contributing to increasing acute pancreatitis (AP) hospitalizations remain unknown. We sought to analyze etiological factors and outcomes of increasing AP hospitalizations.

Methods: Utilizing the Nationwide Inpatient Sample, retrospective analyses of adult (≥18 years) inpatient admissions with a primary diagnosis of AP (N = 2,016,045) were performed. Patient hospitalizations from 2009 to 2012 were compared with those from 2002 to 2005.

Results: Compared with 2002–2005, there was a 13.2% (P < 0.001) increase in AP admissions in 2009–2012. Multivariate analysis adjusted for “period,” patient and hospital demographics, AP etiologies, and disease associations demonstrated an increase in the odds of associated chronic pancreatitis (CP) [2002–2005: odds ratio, (OR), 32.04; 95% confidence interval (CI), 30.51–33.64; 2009–2012: OR, 35.02; 95% CI, 33.94–36.14], whereas associated odds of gallstones (2002–2005: OR, 36.37; 95% CI, 35.32–37.46; 2009–2012: OR, 29.85; 95% CI, 29.09–30.64) decreased. Compared with 2002–2005, the AP-related mortality decreased in 2009–2012 (1.62%–0.79%, P < 0.001) and was lower in AP with associated CP (0.65%–0.26%; P < 0.001) compared with AP without CP.

Conclusion: In the preceding decade, AP hospitalizations increased, but associated mortality declined. Associated CP has emerged as a leading contributor for AP-related hospitalizations. Further research is needed to identify novel interventions to prevent disease progression of AP.

From the *Section of Pancreatic Disorders and †Section of Advanced Endoscopy, Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center; ‡The Ohio State University College of Medicine; and §Division of Biostatistics, College of Public Heath, The Ohio State University Wexner Medical Center, Columbus, OH.

Received for publication May 6, 2016; accepted October 16, 2016.

Address correspondence to: Somashekar G. Krishna, MD, MPH, Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 2nd Floor, 395 W. 12th Avenue, Columbus, OH 43210 (e-mail: sgkrishna@gmail.com).

Funding sources: This publication was supported in part (PH and DC) by the National Institutes of Diabetes and Digestive and Kidney Diseases and National Cancer Institute under award number U01DK108327.

The authors declare no conflict of interest.

Author contributions: Somashekar Krishna: study concept and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, critical revision of the manuscript for important intellectual content, study supervision.

Amrit Kamboj: analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.

Phil Hart: study concept and design, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.

Alice Hinton: acquisition of data, analysis and interpretation of data, drafting of the manuscript, statistical analysis, and critical revision of the manuscript for important intellectual content.

Darwin Conwell: study concept and design, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.

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