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Acute pancreatitis: 31-Year trends in incidence and mortality – A Danish population-based cohort study

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Background: Objectives: Increasing incidence rates and declining mortality rates have made acute pancreatitis a common cause of hospitalization. We aimed to examine 31-year trends in first-time hospitalization for acute pancreatitis, the subsequent short-term and long-term mortality, and the prognostic impacts of age, sex, and comorbidity. Methods: In this nationwide Danish population-based cohort study of 47,711 incident cases, we computed the annual sex-specific age-standardized incidence rates of acute pancreatitis for 1988–2018. Among patients with incident hospitalization for acute pancreatitis, we computed sex-specific 30-day and 31–365-day mortality rates, stratified them, and performed proportional-hazards regression to estimate mortality rate ratios adjusted for sex, age, and comorbidity, measured by Charlson Comorbidity Index categories. Results: From 1988 to 2018, the standardized incidence rate of acute pancreatitis per 100,000 person-years increased by 29% for men (28.8–37.0%) and by 148% for women (15.7–38.9%). Among patients with pancreatitis, the 30-day mortality declined from 10.0% in those diagnosed in 1988–1992 to 6.3% for those diagnosed in 2013–2017. The corresponding 31–365 day mortality increased from 5.5% to 6.0%. In comparing periods 1988–1992 and 2013–17, the adjusted 30-day mortality rate ratio was 0.36 (95% confidence interval: 0.32–0.41) and the adjusted 31–365 day mortality rate ratio was 0.64 (95% confidence interval: 0.56–0.74). Comorbidity was a strong predictor of mortality among patients with pancreatitis. Conclusions: Over the 31 years of observations, annual rates of acute pancreatitis more than doubled among women, converging with those among men. The comorbidity burden was a strong prognostic factor for short and long-term mortality. Treatments for acute pancreatitis should focus on existing comorbidities.

OriginalsprogEngelsk
TidsskriftPancreatology
Vol/bind20
Nummer7
Sider (fra-til)1332-1339
Antal sider8
ISSN1424-3903
DOI
StatusUdgivet - okt. 2020

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