Abstract
BackgroundThe epidemiology of acute pancreatitis in the United States is largely unknown, particularly episodes that lead to an emergency department (ED) visit. We sought to address this gap and describe ED practice patterns.MethodsData were collected from the National Hospital Ambulatory Medical Care Survey between 1993 and 2003. We examined demographic factors and ED management including medication administration, diagnostic imaging, and disposition.ResultsED visits for acute pancreatitis increased over the study period from the 1994 low of 128,000 visits to a 2003 peak of 318,000 visits (p = 0.01). The corresponding ED visit rate per 10,000 U.S. population also increased from 4.9 visits (95%CI, 3.1–6.7) to 10.9 (95%CI, 7.6–14.3) (p = 0.01). The average age for patients making ED visits for acute pancreatitis during the study period was 49.7 years, 54% were male, and 27% were black. The ED visit rate was higher among blacks (14.7; 95%CI, 11.9–17.5) than whites (5.8; 95%CI, 5.0–6.6). At 42% of ED visits, patients did not receive analgesics. At 10% of ED visits patients underwent CT or MRI imaging, and at 13% of visits they underwent ultrasound testing. Two-thirds of ED visits resulted in hospitalization. Risk factors for hospitalization were older age (multivariate odds ratio for each increasing decade 1.5; 95%CI, 1.3–1.8) and white race (multivariate odds ratio 2.3; 95%CI, 1.2–4.6).ConclusionED visits for acute pancreatitis are rising in the U.S., and ED visit rates are higher among blacks than whites. At many visits analgesics are not administered, and diagnostic imaging is rare. There was greater likelihood of admission among whites than blacks. The observed race disparities in ED visit and admission rates merit further study.
Highlights
The epidemiology of acute pancreatitis in the United States is largely unknown, episodes that lead to an emergency department (ED) visit
Analgesics were administered during 58% (95%confidence intervals (CIs), 53– 63%) of ED visits for acute pancreatitis
This study provides the first U.S estimates of ED visits for acute pancreatitis
Summary
The epidemiology of acute pancreatitis in the United States is largely unknown, episodes that lead to an emergency department (ED) visit. Acute pancreatitis is a relatively common condition, but the incidence throughout the Western world varies widely. Hospital admission rates of 1.5 cases per 10,000 in Southern England and 7.3 per 10,000 in Finland have been reported in various European studies. Investigators have described varied demographic characteristics and treatment patterns for different (page number not for citation purposes). No European studies have examined emergency department (ED) visit rates for acute pancreatitis. This national study of U.S ED visits over an 11-year period stands to provide the most complete epidemiologic picture to date of pancreatitis in the U.S, offering insight into recent trends in ED visits, the overall burden of the disease in the U.S, and the demographic characteristics of patients
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