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ABSTRACTS: BILIARY/PANCREAS

Acute Pancreatitis Mortality Trend in the United States: 2006-2013

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Natov, Nikola MD; Keo, Thormika MD, PhD; Hegde, Sanjay MD

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American Journal of Gastroenterology: October 2015 - Volume 110 - Issue - p S16
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Introduction: Acute pancreatitis (AP) carries significant morbidity with an associated mortality rate of 5%. Although the incidence of AP and factors leading to hospitalization and death were recently described, demographic characteristics of AP mortality in the United States have not been previously reported. The aim of this study is to define the features of AP mortality from underlying alcohol, biliary, or drug/other causes by gender and age using a national database.

Methods: The Wide-ranging Online Data for Epidemiologic Research (WONDER), a publicly available database created by the Center for Disease Control and Prevention (CDC), was queried for AP mortality from 2006 through 2013. Deaths from AP were identified by ICD-10 code (K85.1-K85.9), gender, and age. Individuals younger than age 25 years were excluded from the study.

Results: Males had a higher mortality rate from AP over the 8 year time period (13,642 male deaths vs. 10,121 female deaths, P < 0.05). The average yearly age-adjusted mortality rate for both genders was 0.9 deaths per 100,000 (figure 1). In men, the peak number of deaths occurred in the 55-64 age group (figure 2). In women, the total number of deaths from AP directly correlated with increasing age (figure 3). Mortality from alcoholic AP followed a Gaussian distribution, peaking between the ages of 45-54 and declined with older age in both genders. Total deaths from biliary AP were less than deaths from alcoholic AP amongst both genders and all age groups. Mortality from biliary AP was not significantly different between the compared age groups in both men and women, P > 0.05 (figures 2 and 3).

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Figure 1
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Figure 2
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Figure 3

Conclusion: In the United States, mortality from AP exceeds 2,500 deaths per year. Men are more greatly affected than women, and the majority of men die during middle age while mortality is highest in older women. The observed decline in deaths from alcoholic AP among older age groups may reflect survivorship bias. While alcoholic AP is typically managed with supportive care, the underlying insult in biliary AP, choledocholithiasis, can be treated via endoscopic retrograde cholangiopancreatography (ERCP) which may explain the lower mortality of biliary AP. Further study is needed to identify the clinical features of this at-risk cohort to improve survival in alcoholic AP.

© The American College of Gastroenterology 2015. All Rights Reserved.