title: National trends in incidence and outcomes of acute pancreatitis among type 2 diabetics and non-diabetics in Spain (2001-2011).
abstract: BACKGROUND
  Diabetes is often observed in patients with acute pancreatitis (AP). Our aim was to compare trends in the clinical epidemiology and outcomes of AP in diabetic and non-diabetic patients in Spain.
  
  
  METHODS
  We conducted a retrospective observational study. We identified all patients who had a diagnosis of AP using national hospital discharge data (2001-2011). The incidence of discharges of patients with AP was calculated, stratified by diabetes status. We calculated length of stay and in-hospital mortality (IHM). We applied joinpoint log-linear regression to identify the years in which changes in tendency occurred in the diagnosis of AP. The multivariate analysis was adjusted for age, sex, year and Charlson comorbidity index (CCI).
  
  
  RESULTS
  The total number of subjects who had a diagnosis of AP was 282,349. Of them, 42,009 (14.9%) had type 2 diabetes. The annual percentage of change in the incidence of AP for the whole period was 4.90% for those suffering from type 2 diabetes and almost null (0.1%) for those without this disease. Among hospitalized patients with type 2 diabetes and acute pancreatitis, those with a CCI equal to or greater than three had 5.53 times more probability of dying in the hospital than those with a CCI of zero. The corresponding OR for the non-diabetic group was 6.50 (95%CI 6.15-6.87). Suffering from type 2 diabetes was significantly associated with a lower risk of dying in the hospital with a diagnosis of AP (OR 0.82; 95% CI 0.78-0.86).
  
  
  CONCLUSIONS
  In Spain, time trend analyses suggest that the incidence of AP is increasing more among those with prevalent type 2 diabetes than among those without this disease. Type 2 diabetes was associated with a lower risk of dying in hospital with AP.
authors.affiliation: Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, Spain. Electronic address: manuel.mendez@salud.madrid.org.
authors.forename: Manuel
authors.initials: M
authors.lastname: Méndez-Bailón
authors.affiliation: Servicio de Medicina Interna, Hospital Sureste Arganda del Rey, Madrid, Spain.
authors.forename: Jose María
authors.initials: JM
authors.lastname: de Miguel Yanes
authors.affiliation: Universidad Rey Juan Carlos I, Departamento de Epidemiologia, Madrid, Spain.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez-García
authors.affiliation: Universidad Rey Juan Carlos I, Departamento de Epidemiologia, Madrid, Spain.
authors.forename: Valentin
authors.initials: V
authors.lastname: Hernández-Barrera
authors.affiliation: Universidad Rey Juan Carlos I, Departamento de Epidemiologia, Madrid, Spain.
authors.forename: Napoleón
authors.initials: N
authors.lastname: Pérez-Farinós
authors.affiliation: Universidad Rey Juan Carlos I, Departamento de Epidemiologia, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: López-de-Andrés
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D017063:Outcome Assessment, Health Care; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Acute; Diabetes; Hospitalization; Mortality; Pancreatitis; Trends