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Pancreas. 2006 Nov;33(4):323-30.

Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review.

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Division of Gastroenterology and Hepatology, John L. McClellan Memorial Veterans Hospital & University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

Erratum in

  • Pancreas. 2007 Jan;34(1):174.



To systematically review trends in the epidemiology of the first attack of acute pancreatitis (AP) based on reported population-based studies.


From Medline, we retrieved 18 full-length English language peer-reviewed original articles published from 1966 to June 2005 with population-based information on the epidemiology of first-attack AP. Trends over time were analyzed based on study- and country-specific data and the study site (UK vs non-UK).


Eight studies were from the UK and 10 from other European centers. An increase in the annual incidence per 100,000 for first-attack AP was reported in 10 of 12 studies with longitudinal data from 4 countries (UK, Sweden, Denmark, and Netherlands). The overall AP incidence seems to be higher in non-UK studies compared with that of UK, partly explained by a higher incidence of alcoholic pancreatitis in non-UK studies. A linear trend for increase in gallstone pancreatitis incidence over time was observed irrespective of the study site (UK or non-UK). The AP incidence and mortality increased with age. Gallstone pancreatitis was more common in female subjects, and alcoholic pancreatitis was more common in middle-aged male subjects. The AP case fatality (%) has decreased over time, but the overall population mortality rate per 100,000 has remained unchanged. Recurrence after the first attack is milder with a substantially lower mortality.


The incidence of AP seems to be increasing. Differences in the incidence and etiology between and within countries reflect differences in the risk factor prevalence. Case-fatality rate, but not the population-based mortality rate, decreased over time.

[Indexed for MEDLINE]

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