Pant Chaitanya, Deshpande Abhishek, Sferra Thomas J, Gilroy Richard, Olyaee Mojtaba
From the *Division of Gastroenterology, Hepatology and Motility, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS; and †Medicine Institute Center for Value Based Care Research, Cleveland Clinic; and ‡Division of Pediatric Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Case Western Reserve University School of Medicine, UH Rainbow Babies & Children's Hospital, Cleveland, OH.
J Investig Med. 2015 Apr;63(4):646-8. doi: 10.1097/JIM.0000000000000154.
The objective of this study was to describe the epidemiology and trends in pediatric acute pancreatitis (AP)-associated emergency department (ED) visits in the United States.
Estimates of AP-associated ED visits were calculated in children from birth to 19 years of age using the Nationwide Emergency Department Sample.
From 2006 to 2011, there were an estimated total of 78,787 ED visits associated with the diagnosis of AP. The greatest number of ED visits occurred in children 15 to 19 years of age (67.0%). A majority of patients were subsequently admitted to the hospital for further care (74.1%). Risk factors independently associated with an increased rate of hospital admission included 3 or more comorbid conditions (adjusted odds ratio [aOR] 12.81; 95% confidence interval [CI], 11.29-14.56), children younger than 5 years (aOR, 1.73; 95% CI, 1.58-1.89), presentation to a teaching hospital (aOR, 1.68; 95% CI, 1.62-1.74) or a hospital in the Western region of the United States (aOR, 1.48; 95% 1.42-1.54), and health coverage with Medicaid (aOR, 1.23; 95% CI, 1.17-1.29). Acute pancreatitis-associated ED visits increased from 14.5 per 100,000 children in 2006 to 16.1 per 100,000 children in 2011 (11.42% increase; P < 0.01).
There has been an increasing incidence of AP-associated ED visits in children from 2006 to 2011.
本研究的目的是描述美国儿科急性胰腺炎（AP）相关的急诊科（ED）就诊的流行病学情况及趋势。
使用全国急诊科样本计算出生至19岁儿童中与AP相关的ED就诊估计数。
2006年至2011年，估计共有78787次与AP诊断相关的ED就诊。就诊次数最多的是15至19岁的儿童（67.0%）。大多数患者随后被收住入院接受进一步治疗（74.1%）。与住院率增加独立相关的危险因素包括3种或更多合并症（调整优势比[aOR]12.81；95%置信区间[CI]，11.29 - 14.56）、5岁以下儿童（aOR，1.73；95% CI，1.58 - 1.89）、到教学医院就诊（aOR，1.68；95% CI，1.62 - 1.74）或到美国西部地区的医院就诊（aOR，1.48；95% CI，1.42 - 1.54）以及医疗补助覆盖（aOR，1.23；95% CI，1.17 - 1.29）。与急性胰腺炎相关的ED就诊从2006年每10万名儿童中的14.5次增加到2011年的每10万名儿童中的16.1次（增加11.42%；P < 0.01）。
2006年至2011年，儿童中与AP相关的ED就诊发病率呈上升趋势。
