title: Polypharmacy and risk of acute pancreatitis.
abstract: Drug-induced pancreatitis is receiving increased medical and epidemiological attention. However, as no study has examined the role of polypharmacy per se in the development of acute pancreatitis, we examined the association between polypharmacy and risk of acute pancreatitis.
  
  
  
  A nationwide case-control study was conducted between 2006 and 2008 of Swedish people aged 40-84 years. The Swedish Patient Register was used to identify 6161 cases of first-episode acute pancreatitis. The Swedish Register of the Total Population was used to randomly select 61 637 controls from the general population using frequency-based density sampling, matched for age, sex, and calendar year. The Swedish Prescribed Drug Register was used to assess polypharmacy, defined as the number of unique drugs prescribed during the last 6 months before the index date (i.e. the date of acute pancreatitis for cases and a random date for controls). Odds ratios (ORs), with 95% confidence intervals (CIs), of acute pancreatitis were estimated by unconditional logistic regression, adjusted for matching variables and potential confounding factors.
  
  
  
  The number of prescribed drugs was associated with a dose-dependent increase in the risk of acute pancreatitis. In the multivariable-adjusted model, compared to those without any prescriptions, the OR was 1.69 (95%CI: 1.55-1.86) for persons with 1-2 drugs, 2.40 (2.20-2.62) for 3-5 drugs, 3.17 (2.88-3.48) for 6-9 drugs, and 4.57 (4.12-5.06) for 10 or more drugs.
  
  
  
  This population-based case-control study shows a dose-dependent association between increasing polypharmacy and risk of acute pancreatitis. These findings provide further insights into drug-induced pancreatitis. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Division of Surgery, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Razavi
authors.affiliation: Division of Surgery, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.|Section of Upper Gastrointestinal Surgery, Centre of Gastrointestinal Disease, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Lindblad
authors.affiliation: Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Bexelius
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Viktor
authors.initials: V
authors.lastname: Oskarsson
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Omid
authors.initials: O
authors.lastname: Sadr-Azodi
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. rickard.ljung@ki.se.
authors.forename: Rickard
authors.initials: R
authors.lastname: Ljung
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000139:chemically induced* / Q000453:epidemiology; D019338:Polypharmacy; D055553:Prescription Drugs / Q000008:administration & dosage / Q000009:adverse effects*; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
chemical_list: D055553:Prescription Drugs
keywords: comorbidity; confounding; medicines; pharmacoepidemiology; socioeconomic factors