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Pancreatology. 2016 Jul-Aug;16(4):542-50. doi: 10.1016/j.pan.2016.04.008. Epub 2016 Apr 23.

Case-fatality from acute pancreatitis is decreasing but its population mortality shows little change.

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Saint Louis University Center for Outcomes Research (SLUCOR) and Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Louis University, St. Louis, MO, USA.
Department of Internal Medicine, Division of Gastroenterology, Hepatology & Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. Electronic address:



The reasons for changing epidemiology of acute pancreatitis (AP) are poorly defined. We hypothesized that trends for severity, case-fatality and population mortality from AP will provide an insight into the rising burden of AP in the population. We evaluated trends in the hospitalizations, case-fatality, severity and population mortality related to AP in the US population.


We used the National Hospital Discharge Survey to calculate age, sex and race standardized hospitalizations of and case-fatality rates for AP, and Vital Statistics to calculate AP-related population mortality from 1983 to 2010, using 2010 US census as the reference.


Number of discharges per 100,000 population with primary diagnosis of AP increased 2 times from 42.4 (95% CI 38.2-46.5) during 1983-1986 to 85.4 (95% CI 62.8-108.1) during 2007-2010. During corresponding intervals, case-fatality from AP decreased 62% from 2.02% (95% CI 2.01-2.04) to 0.79% (95% CI 0.78-0.80), but population mortality per million population due to AP as primary cause remained stable from 9.28 (95% CI 8.94-9.62) to 9.91 (95% CI 9.56-10.26), and from AP as any cause decreased significantly (but only 12%) from 20.87 (95% CI 20.36-21.38) to 18.48 (95% CI 18.00-18.96). Prevalence of severe AP increased from 5% (95% CI 4.95-5.05%) during 1991-1994 to 9.78% (95% CI 9.73-9.83%) during 2007-2010.


An increasing prevalence of severe disease suggests true population increase to be an important contributor to the rising incidence of AP. A lack of proportional increase in population mortality suggests the impact of medical advances in the evaluation and management of AP.


Epidemiology; Incidence; Mortality; Pancreatitis; Severity; Trend

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