Original Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. May 28, 2013; 19(20): 3018-3026
Published online May 28, 2013. doi: 10.3748/wjg.v19.i20.3018
Incidence and mortality of acute and chronic pancreatitis in the Netherlands: A nationwide record-linked cohort study for the years 1995-2005
BW Marcel Spanier, Marco J Bruno, Marcel GW Dijkgraaf
BW Marcel Spanier, Department of Gastroenterology and Hepatology, Rijnstate Hospital, 6800 TA Arnhem, The Netherlands
Marco J Bruno, Department of Gastroenterology and Hepatology, Erasmus Medical Center, 3015 CE Rotterdam, The Netherlands
Marcel GW Dijkgraaf, Clinical Research Unit, Academic Medical Center, 1105 AZ Amsterdam, The Netherlands
Author contributions: All the authors contributed equally to this manuscript.
Supported by Unrestricted Grant from Axcan Pharma Incorporate, Canada, to Spanier BWM; Dutch Society of Gastroenterology, Gastrostart Project Number 2007-7
Correspondence to: BW Marcel Spanier, MD, PhD, Department of Gastroenterology and Hepatology, Rijnstate Hospital, PO Box 9555, 6800 TA Arnhem, The Netherlands. mspanier@rijnstate.nl
Telephone: +318-8005-8888 Fax: +318-8005-8853
Received: January 9, 2013
Revised: March 5, 2013
Accepted: April 10, 2013
Published online: May 28, 2013
Processing time: 138 Days and 10.5 Hours
Abstract

AIM: To analyze trends in incidence and mortality of acute pancreatitis (AP) and chronic pancreatitis (CP) in the Netherlands and for international standard populations.

METHODS: A nationwide cohort is identified through record linkage of hospital data for AP and CP, accumulated from three nationwide Dutch registries: the hospital discharge register, the population register, and the death certificate register. Sex- and age-group specific incidence rates of AP and CP are defined for the period 2000-2005 and mortality rates of AP and CP for the period 1995-2005. Additionally, incidence and mortality rates over time are reported for Dutch and international (European and World Health Organization) standard populations.

RESULTS: Incidence of AP per 100000 persons per year increased between 2000 and 2005 from 13.2 (95%CI: 12.6-13.8) to 14.7 (95%CI: 14.1-15.3). Incidence of AP for males increased from 13.8 (95%CI: 12.9-14.7) to 15.2 (95%CI: 14.3-16.1), for females from 12.7 (95%CI: 11.9-13.5) to 14.2 (95%CI: 13.4-15.1). Irregular patterns over time emerged for CP. Overall mean incidence per 100000 persons per year was 1.77, for males 2.16, and for females 1.4. Mortality for AP fluctuated during 1995-2005 between 6.9 and 11.7 per million persons per year and was almost similar for males and females. Concerning CP, mortality for males fluctuated between 1.1 (95%CI: 0.6-2.3) and 4.0 (95%CI: 2.8-5.8), for females between 0.7 (95%CI: 0.3-1.6) and 2.0 (95%CI: 1.2-3.2). Incidence and mortality of AP and CP increased markedly with age. Standardized rates were lowest for World Health Organization standard population.

CONCLUSION: Incidence of AP steadily increased while incidence of CP fluctuated. Mortality for both AP and CP remained fairly stable. Patient burden and health care costs probably will increase because of an ageing Dutch population.

Keywords: Acute pancreatitis; Chronic pancreatitis; Epidemiology; Incidence; Mortality

Core tip: Large scale epidemiological studies reporting time trends of incidence and mortality of chronic pancreatitis (CP) are strikingly scarce compared to the also limited epidemiological studies on acute pancreatitis (AP). Reported are the Dutch incidence rates of AP and CP for the period 2000-2005, and mortality rates of AP and CP for the period 1995-2005. The incidence rates of AP steadily increased while the incidence of CP fluctuated. Population mortality for both AP and CP remained fairly stable. Both incidence and mortality rates increased markedly by age. So, especially in ageing populations, it is to be expected that patient burden and health care costs will increase.