Acute pancreatitis and the influence of socioeconomic deprivation

Background: A comprehensive epidemiological study of acute pancreatitis (AP) using reliable objective methods of patient identification with the inclusion of socioeconomic factors has not been reported previously. Methods: The study included all patients with AP identified by raised serum amylase or lipase levels admitted to 18 hospitals over 6 months. Clinical records were reviewed to confirm the diagnosis, aetiology and outcome. Patients were stratified into quintiles of socioeconomic deprivation. Age-standardized incidence (ASI) and mortality were calculated. Results: Clinical data were reviewed for all 963 identified patients. The ASI was 56.5 per 10(5) per annum, double the highest figure reported previously in the UK. Univariable logistic regression analysis showed a high ASI among older age groups (odds ratio (OR) 1.06 per year; P < 0.001) and in areas of high deprivation (OR 2.40 between least and most deprived; P < 0.001); the latter was predominantly related to alcoholic aetiology (OR 6.50 (95 per cent confidence interval 3.90 to 10.84)). Conclusion: The incidence of AP based on a highly sensitive method of case identification was higher than previously reported. A clear relationship was found between socioeconomic deprivation and incidence of AP, which was largely explained by a higher incidence of alcoholic aetiology.