Epidemiology of Acute Pancreatitis in Hospitalized Children in the United States from 2000-2009

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2014 May 9

PMID 24805879

Citations 30

Authors

Chaitanya Pant

Abhishek Deshpande

Mojtaba Olyaee

Michael P Anderson

Anas Bitar

Marilyn I Steele

Pat F Bass 3rd

Thomas J Sferra

Affiliations

Soon will be listed here.

Abstract

Background: Single-center studies suggest an increasing incidence of acute pancreatitis (AP) in children. Our specific aims were to (i) estimate the recent secular trends, (ii) assess the disease burden, and (iii) define the demographics and comorbid conditions of AP in hospitalized children within the United States.

Methods: We used the Healthcare Cost and Utilization Project Kids' Inpatient Database, Agency for Healthcare Research and Quality for the years 2000 to 2009. Extracted data were weighted to generate national-level estimates. We used the Cochrane-Armitage test to analyze trends; cohort-matching to evaluate the association of AP and in-hospital mortality, length of stay, and charges; and multivariable logistic regression to test the association of AP and demographics and comorbid conditions.

Results: We identified 55,012 cases of AP in hospitalized children (1-20 years of age). The incidence of AP increased from 23.1 to 34.9 (cases per 10,000 hospitalizations per year; P<0.001) and for all-diagnoses 38.7 to 61.1 (P<0.001). There was an increasing trend in the incidence of both primary and all-diagnoses of AP (P<0.001). In-hospital mortality decreased (13.1 to 7.6 per 1,000 cases, P<0.001), median length of stay decreased (5 to 4 days, P<0.001), and median charges increased ($14,956 to $22,663, P<0.001). Children with AP compared to those without the disease had lower in-hospital mortality (adjusted odds ratio, aOR 0.86, 95% CI, 0.78-0.95), longer lengths of stay (aOR 2.42, 95% CI, 2.40-2.46), and higher charges (aOR 1.62, 95% CI, 1.59-1.65). AP was more likely to occur in children older than 5 years of age (aORs 2.81 to 5.25 for each 5-year age interval). Hepatobiliary disease was the comorbid condition with the greatest association with AP.

Conclusions: These results demonstrate a rising incidence of AP in hospitalized children. Despite improvements in mortality and length of stay, hospitalized children with AP have significant morbidity.

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References

Morinville V, Barmada M, Lowe M . Increasing incidence of acute pancreatitis at an American pediatric tertiary care center: is greater awareness among physicians responsible?. Pancreas. 2009; 39(1):5-8. DOI: 10.1097/MPA.0b013e3181baac47. View

Park A, Latif S, Shah A, Tian J, Werlin S, Hsiao A . Changing referral trends of acute pancreatitis in children: A 12-year single-center analysis. J Pediatr Gastroenterol Nutr. 2009; 49(3):316-22. PMC: 3034387. DOI: 10.1097/MPG.0b013e31818d7db3. View

Werlin S, Kugathasan S, Frautschy B . Pancreatitis in children. J Pediatr Gastroenterol Nutr. 2003; 37(5):591-5. DOI: 10.1097/00005176-200311000-00017. View

Bai H, Lowe M, Husain S . What have we learned about acute pancreatitis in children?. J Pediatr Gastroenterol Nutr. 2011; 52(3):262-70. PMC: 3626416. DOI: 10.1097/MPG.0b013e3182061d75. View

Rassekh S, Lorenzi M, Lee L, Devji S, McBride M, Goddard K . Reclassification of ICD-9 Codes into Meaningful Categories for Oncology Survivorship Research. J Cancer Epidemiol. 2011; 2010:569517. PMC: 3018640. DOI: 10.1155/2010/569517. View

Choi B, Lim Y, Yoon C, Kim E, Park Y, Kim K . Acute pancreatitis associated with biliary disease in children. J Gastroenterol Hepatol. 2003; 18(8):915-21. DOI: 10.1046/j.1440-1746.2003.03080.x. View

Nylund C, Goudie A, Garza J, Fairbrother G, Cohen M . Clostridium difficile infection in hospitalized children in the United States. Arch Pediatr Adolesc Med. 2011; 165(5):451-7. PMC: 4683604. DOI: 10.1001/archpediatrics.2010.282. View

Lautz T, Chin A, Radhakrishnan J . Acute pancreatitis in children: spectrum of disease and predictors of severity. J Pediatr Surg. 2011; 46(6):1144-9. DOI: 10.1016/j.jpedsurg.2011.03.044. View

Nydegger A, Heine R, Ranuh R, Gegati-Levy R, Crameri J, Oliver M . Changing incidence of acute pancreatitis: 10-year experience at the Royal Children's Hospital, Melbourne. J Gastroenterol Hepatol. 2007; 22(8):1313-6. DOI: 10.1111/j.1440-1746.2007.04936.x. View

10.

Henderson P, Hansen R, Cameron F, Gerasimidis K, Rogers P, Bisset W . Rising incidence of pediatric inflammatory bowel disease in Scotland. Inflamm Bowel Dis. 2011; 18(6):999-1005. DOI: 10.1002/ibd.21797. View

11.

Morinville V, Husain S, Bai H, Barth B, Alhosh R, Durie P . Definitions of pediatric pancreatitis and survey of present clinical practices. J Pediatr Gastroenterol Nutr. 2012; 55(3):261-5. PMC: 3626452. DOI: 10.1097/MPG.0b013e31824f1516. View

12.

Sanchez-Ramirez C, Larrosa-Haro A, Flores-Martinez S, Sanchez-Corona J, Villa-Gomez A, Macias-Rosales R . Acute and recurrent pancreatitis in children: etiological factors. Acta Paediatr. 2007; 96(4):534-7. DOI: 10.1111/j.1651-2227.2007.00225.x. View

13.

Debanto J, Goday P, Pedroso M, Iftikhar R, Fazel A, Nayyar S . Acute pancreatitis in children. Am J Gastroenterol. 2002; 97(7):1726-31. DOI: 10.1111/j.1572-0241.2002.05833.x. View

14.

Kandula L, Lowe M . Etiology and outcome of acute pancreatitis in infants and toddlers. J Pediatr. 2007; 152(1):106-10, 110.e1. DOI: 10.1016/j.jpeds.2007.05.050. View

15.

Cucchiara S, Stronati L . Incidence in pediatric IBD is rising: help from health administrative data. Inflamm Bowel Dis. 2011; 17(4):1048-9. DOI: 10.1002/ibd.21497. View

16.

Weizman Z, Durie P . Acute pancreatitis in childhood. J Pediatr. 1988; 113(1 Pt 1):24-9. DOI: 10.1016/s0022-3476(88)80523-7. View

17.

Bradley 3rd E . A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992. Arch Surg. 1993; 128(5):586-90. DOI: 10.1001/archsurg.1993.01420170122019. View

18.

Ma M, Bai H, Park A, Latif S, Mistry P, Pashankar D . Risk factors associated with biliary pancreatitis in children. J Pediatr Gastroenterol Nutr. 2011; 54(5):651-6. PMC: 3626418. DOI: 10.1097/MPG.0b013e31823a897d. View

19.

Benchimol E, Fortinsky K, Gozdyra P, van den Heuvel M, Van Limbergen J, Griffiths A . Epidemiology of pediatric inflammatory bowel disease: a systematic review of international trends. Inflamm Bowel Dis. 2010; 17(1):423-39. DOI: 10.1002/ibd.21349. View

20.

Lopez M . The changing incidence of acute pancreatitis in children: a single-institution perspective. J Pediatr. 2002; 140(5):622-4. DOI: 10.1067/mpd.2002.123880. View