Gallstone pancreatitis - A community teaching hospital experience

Goals: The current study reviews the Bridgeport Hospital experience with ga llstone pancreatitis (GP) and examines its incidence by race and gender. St udy: Consecutive patients admitted with acute pancreatitis between October 1994 and October 1996 were identified using discharge diagnosis codes. Demo graphics and clinical information were abstracted. Patients were categorize d as having definite GP, probable GP, and non-GP using the available inform ation. Results: One hundred twenty-three patients met criteria for acute pa ncreatitis. Of these, 40 met the criteria for definite GP; 14, probable; an d 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 yea rs) for probably GP. Patients with definite or probable GP were predominant ly white or Hispanic women and tended to be older. Only 16% of pancreatitis in black patients was associated with gallstones. Elevated alanine aminotr ansferase (ALT > 120 U/L) was highly specific (97%) in predicting GP, with a positive likelihood ratio of 18.3. Abdominal ultrasound was the most wide ly used imaging study. Complication rates were low. There was only one intr ahospital 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 high ly specific in the prediction of GP.