Incidence and case fatality for acute pancreatitis in England: geographical variation, social deprivation, alcohol consumption and aetiology--a record linkage study.
BACKGROUND
Regional studies in the UK indicate that the incidence of acute pancreatitis increased from the 1940s to the 1990s, while case fatality fell until the 1970s but has levelled-off since.


OBJECTIVE
To establish incidence and case fatality for acute pancreatitis in England from 1998 to 2003, to study geographical variation and recent trends in incidence and to study associations with social deprivation and alcohol consumption.


METHODS
Use of national record linkage of in-patient and mortality data for 52 096 people.


RESULTS
Overall incidence was 22.4 per 100 000 population, increasing by 3.1% annually, with largest increases for women aged under 35 years (11% per year) and for men aged 35 to 45 (5.6%). Incidence was higher in northern regions than in southern regions and in areas with high social deprivation and binge drinking. Case fatality was 6.7% at 60 days, higher for alcoholic than gallstones aetiology and was associated with social deprivation and geography.


CONCLUSIONS
Acute pancreatitis is a growing problem in England, particularly among younger women. The findings indicate strongly that alcohol consumption is the main reason for recent increases in incidence, the higher incidence in socially-deprived areas and for the lack of recent improvement in prognosis.
Roberts
S E
SE
School of Medicine, Swansea University, Swansea, UK. stephen.e.roberts@swansea.ac.uk
Williams
J G
JG
Meddings
D
D
Goldacre
M J
MJ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D003625:Data Collection / Q000379:methods; D004739:England / Q000453:epidemiology; D005260:Female; D042882:Gallstones / Q000150:complications / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology* / Q000401:mortality; D019512:Pancreatitis, Alcoholic / Q000453:epidemiology / Q000401:mortality; D011610:Psychosocial Deprivation