Gallstone pancreatitis - A community teaching hospital experience

Goals: The current study reviews the Bridgeport Hospital experience with gallstone pancreatitis (GP) and examines its incidence by race and gender. Study: Consecutive patients admitted with acute pancreatitis between October 1994 and October 1996 were identified using discharge diagnosis codes. Demographics and clinical information were abstracted. Patients were categorized as having definite GP, probable GP, and non-GP using the available information. Results: One hundred twenty-three patients met criteria for acute pancreatitis. Of these, 40 met the criteria for definite GP; 14, probable; and 69, non-GP. The estimated incidence for acute pancreatitis was 45 per 100,000 person-years (95% CI = 41-58 per 100,000 person-years) for definite GP and was 20 per 100,000 person-years (95% CI = 14-25 per 100,000 person years) for probably GP. Patients with definite or probable GP were predominantly white or Hispanic women and tended to be older. Only 16% of pancreatitis in black patients was associated with gallstones. Elevated alanine aminotransferase (ALT > 120 U/L) was highly specific (97%) in predicting GP, with a positive likelihood ratio of 18.3. Abdominal ultrasound was the most widely used imaging study. Complication rates were low. There was only one intrahospital death. Conclusions: The incidence of acute pancreatitis requiring hospitalization at our community hospital in 1994-1996 was 45 (95% CI = 41-58) per 100,000 person-years. Forty percent of these cases were associated with gallstones. Gallstone pancreatitis was more common among the elderly women and the white (white, non-Hispanic) population. Elevated ALT was highly specific in the prediction of GP.