title: Operative Trends for Pancreatic Diseases in the USA: Analysis of the Nationwide Inpatient Sample from 1998-2011.
abstract: The epidemiology of pancreatic diseases is changing. Our aim was to determine the change in indications, frequency, and type of operations being performed for primary pancreatic diseases in the USA. Using the Nationwide Inpatient Sample, all patients aged ≥18 years who underwent pancreatic operations for a primary pancreatic indication between 1998-2011 were identified. Age- and sex-adjusted rates per million adult population were calculated using the 2010 US population as reference. Changes in patient characteristics and outcomes were analyzed. Of 151,454 operations, 82% were resections and 64% were performed for tumors (malignant 52%, benign 12%). Operative rates/million population increased from 41.36 in 1998 to 62.3 in 2011. Population rates increased significantly for distal pancreatectomy, but decreased significantly for drainage procedures (p < 0.05). Additionally, operative rates increased significantly for tumors and cysts/pseudocysts, but decreased significantly for acute pancreatitis (p < 0.05). During this period, mean age, and comorbidity burden for patients undergoing pancreatic operations increased significantly, while their length of hospital stay and in-hospital mortality decreased significantly (p trend <0.05). The number of pancreatic operations performed in the USA is increasing. Although being offered to older patients with more comorbidities, surgeries are being performed with increasing safety and better outcomes.
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Anwar
authors.initials: A
authors.lastname: Dudekula
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Internal Medicine, St. Louis University, St. Louis University, MO, USA.
authors.forename: Satish
authors.initials: S
authors.lastname: Munigala
authors.affiliation: Division of Surgical Oncology, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors.forename: Amer H
authors.initials: AH
authors.lastname: Zureikat
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA. yadavd@upmc.edu.
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Yadav
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity / Q000639:trends; D016208:Databases, Factual; D004322:Drainage / Q000639:trends; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods / Q000639:trends*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D010192:Pancreatic Pseudocyst / Q000601:surgery*; D010195:Pancreatitis / Q000601:surgery*; D014481:United States; D055815:Young Adult
keywords: Cancer; Cystic tumor; Outcome; Pancreas; Pancreatitis; Surgery; Trends