Incidence and mortality of acute and chronic pancreatitis in the Netherlands: a nationwide record-linked cohort study for the years 1995-2005

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.

Figure 1

Incidence rates acute pancreatitis per 100000 persons per year. A: The incidence rates of male and female acute pancreatitis (AP) cases; B: The incidence rates for four major age groups (< 25, 25-49, 50-74 and > 74 years); C (males) and D (females): The original as well as the Dutch 2000, the European and the World Health Organization (WHO) standardized incidence rates of AP.

Figure 2

Incidence rates chronic pancreatitis per 100000 persons per year. A: The incidence rates of male and female chronic pancreatitis (CP) cases; B: The incidence rates for four major age groups (< 25, 25-49, 50-74 and > 74 years); C (males) and D (females): The original as well as the Dutch 2000, the European and the World Health Organization (WHO) standardized incidence rates of CP.

Figure 3

Mortality rates acute pancreatitis per million persons per year. A: The male and female mortality rates of acute pancreatitis (AP) for 1995-2005; B: The mortality rates for four major age groups (< 25, 25-49, 50-74 and > 74 years); C (males) and D (females): The original as well as the Dutch 2000, the European and the World Health Organization (WHO) standardized mortality rates of AP.

Figure 4

Mortality rates chronic pancreatitis per million persons per year. A: The male and female mortality rates of chronic pancreatitis (CP) for 1995-2005; B: The mortality rates for four major age groups (< 25, 25-49, 50-74 and > 74 years); C (males) and D (females): The original as well as the Dutch 2000, the European and the World Health Organization (WHO) standardized mortality rates of CP for 1995-2005.