Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, Palo Alto, California.
Pediatric Gastroenterology, Hepatology, and Nutrition, Stanford University, Palo Alto, California; Surgery, Stanford University, Palo Alto, California.
Gastroenterology. 2018 Aug;155(2):469-478.e1. doi: 10.1053/j.gastro.2018.04.013. Epub 2018 Apr 13.
BACKGROUND & AIMS: Epidemiologic analyses of acute pancreatitis (AP) and chronic pancreatitis (CP) provide insight into causes and strategies for prevention and affect allocation of resources to its study and treatment. We sought to determine current and accurate incidences of AP and CP, along with the prevalence of CP, in children and adults in the United States.
We collected data from the Truven MarketScan Research Databases of commercial inpatient and outpatient insurance claims in the United States from 2007 through 2014 (patients 0-64 years old). We calculated the incidences of AP and CP and prevalence of CP based on International Classification of Diseases, 9th Revision diagnosis codes. Children were defined as 18 years or younger and adults as 19 to 64 years old.
The incidence of pediatric AP was stable from 2007 through 2014, remaining at 12.3/100,000 persons in 2014. Meanwhile, the incidence for adult AP decreased from 123.7/100,000 persons in 2007 to 111.2/100,000 persons in 2014. The incidence of CP decreased over time in children (2.2/100,000 persons in 2007 to 1.9/100,000 persons in 2014) and adults (31.7/100,000 persons in 2007 to 24.7/100,000 persons in 2014). The prevalences of pediatric and adult CP were 5.8/100,000 persons and 91.9/100,000 persons, respectively, in 2014. Incidences of AP and CP increased with age. We found little change in incidence during the first decade of life but linear increases starting in the second decade.
We performed a comprehensive epidemiologic analysis of privately insured, non-elderly adults and children with AP and CP in the United States. Changes in gallstone formation, smoking, and alcohol consumption, along with advances in pancreatitis management, may be responsible for the stabilization and even decrease in the incidences of AP and CP.
急性胰腺炎(AP)和慢性胰腺炎(CP)的流行病学分析为病因和预防策略提供了深入了解,并影响了对其研究和治疗的资源分配。我们旨在确定目前和准确的美国儿童和成人中 AP 和 CP 的发病率以及 CP 的流行率。
我们从美国 Truven MarketScan 研究数据库中收集了 2007 年至 2014 年商业住院和门诊保险索赔数据(患者 0-64 岁)。我们根据国际疾病分类第 9 版诊断代码计算了 AP 和 CP 的发病率和 CP 的流行率。儿童定义为 18 岁或以下,成人定义为 19 至 64 岁。
2007 年至 2014 年,儿科 AP 的发病率保持稳定,2014 年为 12.3/100,000 人。同时,成人 AP 的发病率从 2007 年的 123.7/100,000 人下降到 2014 年的 111.2/100,000 人。儿童 CP 的发病率随时间下降(2007 年为 2.2/100,000 人,2014 年为 1.9/100,000 人)和成人(2007 年为 31.7/100,000 人,2014 年为 24.7/100,000 人)。2014 年,儿科和成人 CP 的患病率分别为 5.8/100,000 人和 91.9/100,000 人。AP 和 CP 的发病率随年龄增长而增加。我们发现生命的前十年发病率变化不大,但从第二个十年开始呈线性增加。
我们对美国私人保险的非老年儿童和成人进行了 AP 和 CP 的全面流行病学分析。胆石形成、吸烟和饮酒习惯的变化以及胰腺炎治疗的进步可能是 AP 和 CP 发病率稳定甚至下降的原因。