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. 2017 Aug;62(8):2133-2140.
doi: 10.1007/s10620-017-4621-z. Epub 2017 Jun 9.

Validation of Demographics, Etiology, and Risk Factors for Chronic Pancreatitis in the USA: A Report of the North American Pancreas Study (NAPS) Group

Darwin L Conwell  1   2 , Peter A Banks  3 , Bimaljit S Sandhu  4 , Stuart Sherman  5 , Samer Al-Kaade  6 , Timothy B Gardner  7 , Michelle A Anderson  8 , C Mel Wilcox  9 , Michele D Lewis  10 , Thiruvengadam Muniraj  11 , Christopher E Forsmark  12 , Gregory A Cote  5 , Nalini M Guda  13 , Ye Tian  14 , Joseph Romagnuolo  15 , Stephen R Wisniewski  14 , Randall Brand  16 , Andres Gelrud  17 , Adam Slivka  16 , David C Whitcomb  16 , Dhiraj Yadav  16
Affiliations

Validation of Demographics, Etiology, and Risk Factors for Chronic Pancreatitis in the USA: A Report of the North American Pancreas Study (NAPS) Group

Darwin L Conwell et al. Dig Dis Sci. 2017 Aug.

Abstract

Background/objectives: Our aim was to validate recent epidemiologic trends and describe the distribution of TIGAR-O risk factors in chronic pancreatitis (CP) patients.

Methods: The NAPS-2 Continuation and Validation (NAPS2-CV) study prospectively enrolled 521 CP patients from 13 US centers from 2008 to 2012. CP was defined by definitive changes in imaging, endoscopy, or histology. Data were analyzed after stratification by demographic factors, physician-defined etiology, participating center, and TIGAR-O risk factors.

Results: Demographics and physician-defined etiology in the NAPS2-CV study were similar to the original NAPS2 study. Mean age was 53 years (IQR 43, 62) with 55% males and 87% white. Overall, alcohol was the single most common etiology (46%) followed by idiopathic etiology (24%). Alcohol etiology was significantly more common in males, middle-aged (35-65 years), and non-whites. Females and elderly (≥65 years) were more likely to have idiopathic etiology, while younger patients (<35 years) to have genetic etiology. Variability in etiology was noted by participating centers (e.g., alcohol etiology ranged from 27 to 67% among centers enrolling ≥25 patients). Smoking was the most commonly identified (59%) risk factor followed by alcohol (53%), idiopathic (30%), obstructive (19%), and hyperlipidemia (13%). The presence of multiple TIGAR-O risk factors was common, with 1, 2, ≥3 risk factors observed in 27.6, 47.6, and 23.6% of the cohort, respectively.

Conclusion: Our data validate the current epidemiologic trends in CP. Alcohol remains the most common physician-defined etiology, while smoking was the most commonly identified TIGAR-O risk factor. Identification of multiple risk factors suggests CP to be a complex disease.

Keywords: Chronic pancreatitis; Epidemiology; Risk factors.

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Conflict of interest statement

Compliance with ethical standards

Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Distribution of physician-defined etiology in the NAPS2-CV study by participating center. Data shown for centers that enrolled 20 or more patients
See this image and copyright information in PMC

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