Chinenye R Dike1, Bridget Zimmerman2, Yuhua Zheng3, Michael Wilschanski4, Steven L Werlin5, David Troendle6, Uzma Shah7, Sarah Jane Schwarzenberg8, John Pohl9, Emily R Perito10, Chee Y Ooi11, Jaimie D Nathan12, Veronique D Morinville13, Brian McFerron14, Maria Mascarenhas15, Asim Maqbool15, Quin Liu16, Tom K Lin12, Sohail Z Husain17, Melvin B Heyman10, Tanja Gonska18, Matthew J Giefer19, Cheryl E Gariepy20, Douglas S Fishman7,21, Melena Bellin8, Bradley Barth6, Maisam Abu-El-Haija12, Mark E Lowe22, Aliye Uc1. 1. Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE. 2. Department of Biostatistics, University of Iowa, Iowa City, IA. 3. Children's Hospital of Los Angeles, Los Angeles, CA. 4. Hadassah Hebrew University Hospital, Jerusalem, Israel. 5. Medical College of Wisconsin, Milwaukee, WI. 6. University of Texas Southwestern Medical School, Dallas, TX. 7. Massachusetts General Hospital for Children, Harvard Medical School, Boston, MA. 8. University of Minnesota Masonic Children's Hospital, Minneapolis, MN. 9. University of Utah, Salt Lake City, UT. 10. University of California San Francisco, San Francisco, CA. 11. School of Women's and Children's Health, Medicine, University of New South Wales and Sydney Children's Hospital Randwick, Sydney, Australia. 12. Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 13. Montreal Children's Hospital, McGill University, Montreal, QC, Canada. 14. Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN. 15. Children's Hospital of Philadelphia, Philadelphia, PA. 16. Cedars-Sinai Medical Center, LA. 17. Stanford University, Palo Alto, CA. 18. Hospital for Sick Children, Toronto, ON. 19. Seattle Children's Hospital, Seattle, WA. 20. Nationwide Children's Hospital, Columbus, OH. 21. Baylor College of Medicine, Houston, TX. 22. Washington University School of Medicine, St. Louis, MO.
Abstract
OBJECTIVE: The aim of the study was to determine whether clinical characteristics and management of pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) differ across INSPPIRE (INternational Study Group of Pediatric Pancreatitis: In Search for a cuRE) sites. STUDY DESIGN: Data were collected from INSPPIRE and analyzed per US regions and "non-US" sites. Between-group differences were compared by Pearson chi-square test. Differences in disease burden were compared by Kruskal-Wallis test. RESULTS: Out of the 479 subjects, 121 (25%) were enrolled in West, 151 (32%) Midwest, 45 Northeast (9%), 78 (16%) South, and 84 (18%) at non-US sites. Hispanic ethnicity was more common in South (P < 0.0001); white race in Northeast (P = 0.009). CP was less common and time from diagnosis of first acute pancreatitis to CP was longer in children at non-US sites (P = 0.0002 and P = 0.011, respectively). Genetic mutations were most common among all groups; PRSS1 variants predominated in Midwest (P = 0.002). Gallstones were more frequent in South (P = 0.002). Endoscopic retrograde cholangiopancreatography (ERCP) and computed tomography (CT) imaging were more commonly utilized in United States compared with non-United States (P < 0.0001), but there were no differences in the use of MRI/MRCP. Disease burden was highest in the West and Midwest, possibly as total pancreatectomy and islet autotransplantation (TPIAT) referral sites were located in these regions. All therapies were less commonly administered in non-US sites (P < 0.0001). CONCLUSIONS: This is the first study to describe geographical variations in the INSPPIRE cohort, which possibly reflect variations in practice and referral patterns. The underlying reason behind the lower frequency of CP and fewer treatments in non-United States sites need to be further explored.
OBJECTIVE: The aim of the study was to determine whether clinical characteristics and management of pediatric acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) differ across INSPPIRE (INternational Study Group of Pediatric Pancreatitis: In Search for a cuRE) sites. STUDY DESIGN: Data were collected from INSPPIRE and analyzed per US regions and "non-US" sites. Between-group differences were compared by Pearson chi-square test. Differences in disease burden were compared by Kruskal-Wallis test. RESULTS: Out of the 479 subjects, 121 (25%) were enrolled in West, 151 (32%) Midwest, 45 Northeast (9%), 78 (16%) South, and 84 (18%) at non-US sites. Hispanic ethnicity was more common in South (P < 0.0001); white race in Northeast (P = 0.009). CP was less common and time from diagnosis of first acute pancreatitis to CP was longer in children at non-US sites (P = 0.0002 and P = 0.011, respectively). Genetic mutations were most common among all groups; PRSS1 variants predominated in Midwest (P = 0.002). Gallstones were more frequent in South (P = 0.002). Endoscopic retrograde cholangiopancreatography (ERCP) and computed tomography (CT) imaging were more commonly utilized in United States compared with non-United States (P < 0.0001), but there were no differences in the use of MRI/MRCP. Disease burden was highest in the West and Midwest, possibly as total pancreatectomy and islet autotransplantation (TPIAT) referral sites were located in these regions. All therapies were less commonly administered in non-US sites (P < 0.0001). CONCLUSIONS: This is the first study to describe geographical variations in the INSPPIRE cohort, which possibly reflect variations in practice and referral patterns. The underlying reason behind the lower frequency of CP and fewer treatments in non-United States sites need to be further explored.
Authors: Veronique D Morinville; Sohail Z Husain; Harrison Bai; Bradley Barth; Rabea Alhosh; Peter R Durie; Steven D Freedman; Ryan Himes; Mark E Lowe; John Pohl; Steven Werlin; Michael Wilschanski; Aliye Uc Journal: J Pediatr Gastroenterol Nutr Date: 2012-09 Impact factor: 2.839
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Authors: Joseph J Palermo; Tom K Lin; Lindsey Hornung; C Alexander Valencia; Abhinav Mathur; Kimberly Jackson; Lin Fei; Maisam Abu-El-Haija Journal: Pancreas Date: 2016-10 Impact factor: 3.327
Authors: Aliye Uc; Emily R Perito; John F Pohl; Uzma Shah; Maisam Abu-El-Haija; Bradley Barth; Melena D Bellin; Kate M Ellery; Douglas S Fishman; Cheryl E Gariepy; Matthew J Giefer; Tanja Gonska; Melvin B Heyman; Ryan W Himes; Sohail Z Husain; Asim Maqbool; Maria R Mascarenhas; Brian A McFerron; Veronique D Morinville; Tom K Lin; Quin Y Liu; Jaimie D Nathan; Sue J Rhee; Chee Y Ooi; Zachary M Sellers; Sarah Jane Schwarzenberg; Jose Serrano; David M Troendle; Steven L Werlin; Michael Wilschanski; Yuhua Zheng; Ying Yuan; Mark E Lowe Journal: Pancreas Date: 2018 Nov/Dec Impact factor: 3.327
Authors: Cheryl E Gariepy; Melvin B Heyman; Mark E Lowe; John F Pohl; Steven L Werlin; Michael Wilschanski; Bradley Barth; Douglas S Fishman; Steven D Freedman; Matthew J Giefer; Tanja Gonska; Ryan Himes; Sohail Z Husain; Veronique D Morinville; Chee Y Ooi; Sarah J Schwarzenberg; David M Troendle; Elizabeth Yen; Aliye Uc Journal: J Pediatr Gastroenterol Nutr Date: 2017-01 Impact factor: 2.839
Authors: Veronique D Morinville; Mark E Lowe; Monika Ahuja; Bradley Barth; Melena D Bellin; Heather Davis; Peter R Durie; Brian Finley; Douglas S Fishman; Steven D Freedman; Cheryl E Gariepy; Matthew J Giefer; Tanja Gonska; Melvin B Heyman; Ryan Himes; Sohail Husain; Soma Kumar; Chee Y Ooi; John F Pohl; Sarah Jane Schwarzenberg; David Troendle; Steven L Werlin; Michael Wilschanski; Elizabeth Yen; Aliye Uc Journal: J Pediatr Gastroenterol Nutr Date: 2014-09 Impact factor: 2.839