title: Time Trend of Outcomes for Severe Acute Pancreatitis After Publication of Japanese Guidelines Based on a National Administrative Database.
abstract: OBJECTIVE
  This study aimed to investigate the recent time trend of outcomes for severe acute pancreatitis after publication of Japanese guidelines based on a national administrative database.
  
  
  METHODS
  A total of 10,400 patients with severe acute pancreatitis were referred to 1021 hospitals between 2010 and 2012 in Japan. We collected patients' data from the administrative database to compare in-hospital mortality (within 28 days and overall), length of stay (LOS), and medical costs during hospitalization. The study periods were categorized into 3 groups according to fiscal year: 2010 (n = 2698), 2011 (n = 3842), and 2012 (n = 3860).
  
  
  RESULTS
  In-hospital mortality within 28 days and overall in-hospital mortality were significantly decreased according to fiscal year (6.3% [2010] vs 5.7% [2011] vs 4.5% [2012], P = 0.005; 7.6% vs 7.1% vs 5.6%, P = 0.002, respectively). However, mean LOS and medical costs were not different between fiscal years (27.0 vs 27.1 vs 26.9 days, P = 0.218; 13,998.0 vs 14,156.4 vs 14,319.2 USD, P = 0.232, respectively).
  
  
  CONCLUSIONS
  This study shows that mortality of severe acute pancreatitis was reduced according to the time course, whereas LOS or medical costs were stable after publication of the Japanese guidelines.
authors.affiliation: From the *Department of Preventive Medicine and Community Health, School of Medicine, and †Department of Emergency Medicine, University of Occupational and Environmental Health; and ‡Department of Surgery, Kitakyushu City Yahata Hospital, Fukuoka, Japan.
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Murata
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Kohji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohtani
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuda
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002648:Child; D016208:Databases, Factual; D005260:Female; D017408:Guidelines as Topic; D017048:Health Care Costs / Q000706:statistics & numerical data; D006739:Hospital Administration; D017052:Hospital Mortality / Q000208:ethnology / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010195:Pancreatitis / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality*; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult