title: Epidemiology of acute pancreatitis in hospitalized children in the United States from 2000-2009.
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.
authors.affiliation: Department of Medicine, Kansas University Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Pant
authors.affiliation: Medicine Institute Center for Value Based Care, Cleveland Clinic, Cleveland, Ohio, United States of America.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Deshpande
authors.affiliation: Department of Medicine, Kansas University Medical Center, Kansas City, Kansas, United States of America.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Olyaee
authors.affiliation: Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Anderson
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
authors.forename: Anas
authors.initials: A
authors.lastname: Bitar
authors.affiliation: Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
authors.forename: Marilyn I
authors.initials: MI
authors.lastname: Steele
authors.affiliation: Departments of Medicine and Pediatrics, Louisiana Health Sciences Center-Shreveport, Shreveport, Louisiana, United States of America.
authors.forename: Pat F
authors.initials: PF
authors.lastname: Bass
authors.affiliation: Department of Pediatrics, Case Western Reserve University School of Medicine, UH Rainbow Babies & Children's Hospital, Cleveland, Ohio, United States of America.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Sferra
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D010195:Pancreatitis / Q000453:epidemiology*; D055815:Young Adult