A population-based assessment of the burden of acute pancreatitis in the United States.
OBJECTIVE
The aim of this study is to investigate the incidence and mortality of emergency department (ED) visits in the United States attributed to acute pancreatitis (AP) and quantify predictors of admission and mortality.


METHODS
Using the nationwide ED sample, all ED visits between 2006 and 2009 for AP were extracted. Multivariable analyses were fitted for prediction of admission and mortality.


RESULTS
A weighted sample of 1,224,121 patient visits with AP was captured. Of those, 75.4% resulted in admission and 0.7% died. Between 2006 and 2009, the incidence of AP ED visits increased from 9.9 to 10.6 per 10,000 person-years. Patients were more likely to be admitted if sicker (Charlson Comorbidity Index score ≥ 3; OR, 6.48; P < 0.001) and if the etiology of pancreatitis was alcoholic versus biliary (OR, 2.20; P < 0.001). They were more likely to die if sicker (Charlson Comorbidity Index score ≥ 3; OR, 1.51; P < 0.001) and covered with Medicare or Medicaid versus private insurance (OR, 1.40; P < 0.001 and OR, 1.45; P < 0.001, respectively).


CONCLUSIONS
Emergency department visits for AP represent a significant burden on US health care. Although mortality is lower than previously reported, significant disparities exist in patients presenting with AP with regard to admission and mortality rates. Further investigations are needed to assess these disparities.
From the *Division of Gastroenterology, Hepatology, and Endoscopy, Center for Pancreatic Disease, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; †Division of Gastroenterology, McGill University, Montreal, Canada; ‡Center for Outcomes Research and Analytics, Henry Ford Health System, Detroit, MI; §Division of Gastroenterology, University of South Carolina, Charleston, SC; ∥Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School; and ¶Harvard School of Public Health, Boston, MA.
Julia
J
McNabb-Baltar
Praful
P
Ravi
Ghislaine Annie
GA
Isabwe
Shadeah Laila
SL
Suleiman
Mohammad
M
Yaghoobi
Quoc-Dien
QD
Trinh
Peter A
PA
Banks
D000208:Acute Disease; D000328:Adult; D016009:Chi-Square Distribution; D017281:Cost of Illness; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data; D010195:Pancreatitis / Q000191:economics* / Q000453:epidemiology / Q000401:mortality; D011159:Population Surveillance / Q000379:methods; D014481:United States / Q000453:epidemiology