Increasing incidence of acute pancreatitis at an American pediatric tertiary care center: is greater awareness among physicians responsible?

OBJECTIVES: Studies show an increased incidence of adult acute pancreatitis (AP) in recent decades. The aim was to review pediatric AP incidence.
METHODS: Retrospective review of computerized databases at the Children's Hospital of Pittsburgh from 1993 to 2004. The International Classification of Diseases, Ninth Revision, code 5770 Acute Pancreatitis was used; results were tabulated by discharge year and month. The incidence of AP was compared with orders for amylase and lipase testings and with the catchment population.
RESULTS: Over the study period, there were a total of 1021 discharge diagnoses of AP (731 first diagnoses). The diagnosis of AP increased from a low of 28 total cases (21 first diagnoses) in 1993 to a high of 141 total cases (109 first diagnoses) in 2004. The catchment population decreased from 882,000 to 826,500. The estimated incidences of first AP admission were 2.4 to 13.2 per 100,000 children (years 1993-2004; r = 0.8339). Linear regression analysis suggests that increased testing for amylase and lipase could account for 94% of the change in all AP admissions (P = 5.1 x 10).
CONCLUSIONS: The increased incidence of AP at the Children's Hospital of Pittsburgh from 1993 to 2004 may have been primarily driven by increased testing for the disease.