title: Changing referral trends of acute pancreatitis in children: A 12-year single-center analysis.
abstract: BACKGROUND
  Acute pancreatitis is a painful inflammatory disorder known to occur in children. Recent reports, primarily on the basis of adult data, have suggested an increasing incidence. However, pediatric studies are limited.
  
  
  OBJECTIVE
  The study was performed to examine the frequency of acute pancreatitis in a pediatric population from 1994 to 2007 and to characterize etiologies by age subsets.
  
  
  METHODS
  In this retrospective study, cases of pancreatitis were identified by ICD-9 codes and subjected to inclusion criteria.
  
  
  RESULTS
  Two hundred and seventy-one cases of pancreatitis met inclusion criteria. Mean age of the subjects was 13.1 +/- 5.6 years. The recurrence rate was 15.3%. Biliary disease was the most common etiology (32.6%). Acute pancreatitis cases evaluated at a single tertiary care center increased 53% between 1995 to 2000 and 2001 to 2006 (P < 0.02). However, when cases were normalized by all annual pediatric emergency department visits for all medical reasons, the increase was reduced to 22% and lost statistical significance (P = 0.16). The rise was not associated with a change in etiologies or body mass index (BMI).
  
  
  CONCLUSIONS
  This is the first report demonstrating that an increase in pediatric pancreatitis may in part be due to growing referrals to tertiary care centers. The data on etiologies, particularly with regard to differing ages, may be helpful in managing children who present with acute pancreatitis.
authors.affiliation: Department of Pediatrics, Yale University, New Haven, CT, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Park
authors.forename: Sahibzada Usman
authors.initials: SU
authors.lastname: Latif
authors.forename: Ahsan U
authors.initials: AU
authors.lastname: Shah
authors.forename: Jianmin
authors.initials: J
authors.lastname: Tian
authors.forename: Steven
authors.initials: S
authors.lastname: Werlin
authors.forename: Allen
authors.initials: A
authors.lastname: Hsiao
authors.forename: Dinesh
authors.initials: D
authors.lastname: Pashankar
authors.forename: Vineet
authors.initials: V
authors.lastname: Bhandari
authors.forename: Anil
authors.initials: A
authors.lastname: Nagar
authors.forename: Sohail Zakiuddin
authors.initials: SZ
authors.lastname: Husain
mesh_terms: D000293:Adolescent; D001660:Biliary Tract Diseases / Q000150:complications*; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010195:Pancreatitis / Q000453:epidemiology* / Q000209:etiology; D012008:Recurrence; D012017:Referral and Consultation / Q000639:trends*; D012189:Retrospective Studies; D017678:Sex Distribution