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The Epidemiology and Burden of Childhood Chronic Pancreatitis in South Australia
Tristan J Bampton1, Richard Couper2, Sanjeev Khurana3
1School of Public Health, University of Adelaide, Adelaide, Australia; Central and Northern Adelaide Renal and Transplantation Services, Royal Adelaide Hospital, Adelaide, Australia.
Insights
Pediatric chronic pancreatitis is rare but significantly impacts children, leading to increased hospitalizations and school absences. This condition strains public health services and affects educational engagement.
Area of Science:
- Pediatric Gastroenterology
- Public Health
- Epidemiology
Background:
- Chronic pancreatitis in children is a debilitating condition with significant health and social implications.
- Understanding its prevalence and impact is crucial for resource allocation and patient care.
Purpose of the Study:
- To determine the longitudinal prevalence and incidence of chronic pancreatitis in children.
- To assess the impact of pediatric chronic pancreatitis on healthcare utilization and education.
Main Methods:
- A population-based cohort study using administrative data linkage in South Australia (2000-2019).
- Inclusion of 73 incident cases of chronic pancreatitis diagnosed before age 19.
- Comparison with age- and sex-matched controls from the general population and diabetic cohorts.
Main Results:
- The prevalence and incidence of pediatric chronic pancreatitis were estimated at 6.8/100,000 and 0.98/100,000 per year, respectively.
- Children with chronic pancreatitis experienced significantly higher rates of hospital visits (11-fold), emergency department visits (5-fold), and ICU admissions (9-fold) compared to controls.
- A notable proportion (32.8%) of cases occurred in Aboriginal and/or Torres Strait Islander children, and affected children had double the rate of school absence.
Conclusions:
- Pediatric chronic pancreatitis necessitates substantial public health resources.
- Affected children face significant challenges in educational engagement due to the disease's impact.
Objective:
To assess longitudinal, population-based data on the prevalence and impact of chronic pancreatitis in children.
Study Design:
Administrative data linkage was used to ascertain an index cohort consisting of all individuals who had an initial diagnosis of chronic pancreatitis before age 19 years in the South Australian public hospital system between June 2000 and June 2019. Age- and sex-matched controls were drawn from the general population of South Australia, children with type 1 diabetes, and children with type 2 diabetes. Main outcomes and measures included hospital visits, days in hospital, emergency department (ED) visits, intensive care unit (ICU) admissions, education comparators, and incidence and prevalence estimates.
Results:
A total of 73 incident cases were identified. The crude prevalence and incidence of pediatric chronic pancreatitis were estimated at 6.8/100 000 and 0.98/100 000 per year, respectively. Of the index cohort, 24 cases (32.8%) of pediatric chronic pancreatitis were identified as occurring in children of Aboriginal and/or Torres Strait Islander descent. Compared with matched general population controls, children with chronic pancreatitis averaged 11-fold more hospital visits, 5-fold more ED visits, and 9-fold more ICU admissions; spent 10-fold more days in the hospital; and had a 2-fold higher rate of absence from school (P < .001 for all). Similarly, children with chronic pancreatitis used substantially more health resources than children with type 1 or 2 diabetes.
Conclusions:
Pediatric patients with chronic pancreatitis consume a high volume of public health services and are significantly impacted in their ability to engage in education.
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