Pancreatitis in the Complex Care Population: Presentation, Incidence, and Severity

Area of Science:

• Pediatric Gastroenterology
• Complex Care Medicine
• Epidemiology

Background:

• Children with Medical Complexity (CMC) often present with unique health challenges.
• Pancreatitis incidence and risk factors in CMC are not well-defined.
• Understanding these factors is crucial for timely diagnosis and management.

Purpose of the Study:

• To determine the incidence and clinical presentation of pancreatitis in CMC.
• To evaluate the severity of pancreatitis in this population.
• To identify specific risk factors associated with pancreatitis in CMC.

Main Methods:

• Retrospective chart review of 112 CMC patients from January 2010 to December 2019.
• Data included demographics, diagnoses, pancreatitis type, symptoms, imaging, severity, and risk factors.
• Diagnosis and severity assessed using North American Society for Pediatric Gastroenterology, Hepatology and Nutrition criteria.

Main Results:

• Pancreatitis incidence in CMC was 336/100,000 patient-years, significantly higher than the general pediatric population.
• Most common underlying diagnoses were seizures (67%) and cerebral palsy (65%); 88% had multiple diagnoses.
• Abdominal pain was the predominant symptom (50%), and most initial episodes were mild (82%). Adult CMC patients had higher rates of medication-related pancreatitis (70% vs. 38%).

Conclusions:

• The CMC population exhibits a high incidence of pancreatitis.
• Unique risk factors are present in CMC compared to general pediatric populations.
• This underscores the need for specialized surveillance and care for pancreatitis in CMC.