Epidemiology of First-Attack Acute Pancreatitis in Taiwan From 2000 Through 2009

Abstract

This study aimed to describe a 10-year epidemiological trend of patients with first-attack acute pancreatitis (AP) in Taiwan. We analyzed 107,349 patients with first-attack AP from the Taiwan National Health Insurance Research Database between 2000 and 2009. Severe cases were defined according to a modified Atlanta classification. Incidence rates were standardized by direct method. During the study period, the median age of the patients increased from 49 to 55 years and the proportion of men decreased from 66.8% to 62.3%. The averaged annual incidence of first-attack AP was estimated at 36.9 per 100,000 persons and changed only slightly. Stratified analyses showed that the incidence increased in children (<15 years), elderly people (≥ 65 years), and patients with biliary cause, but decreased in young to middle-aged men (15-64 years). The prevalence of severe cases increased from 21.0% to 22.3%, which was mainly caused by an increase of acute organ dysfunction (from 9.7% to 14.1%). Despite that, hospital mortality decreased from 4.3% to 3.3% for all cases and from 18.5% to 13.3% for severe ones. The overall incidence of first-attack AP changed slightly in Taiwan, which differs from the increasing trend observed in most Western countries. Although more patients had severe attacks in recent years, hospital mortality declined.