Incidence, prevalence, and comorbidities of chronic pancreatitis: A 7-year population-based study

Table 1 The comorbidities and the corresponding International Classification of Diseases, Tenth Revision codes

Comorbidities	ICD-10 codes
Diabetes	E10, E11, E12, E13, E14
Type I diabetes	E10
Type II diabetes	E11
Secondary diabetes	E13, E14
Hypertension	I10, I11, I12, I13, I15, O10
Dyslipidemia	E78
Cholelithiasis	K80, O99.603, K56.3
Fatty liver disease	K76.0, K70.0
Alcoholic fatty liver disease	K70.0
Coronary heart disease	I21, I22, I23, I24, I25
Cerebrovascular disease	I60, I61, I62, I63, I64, I65, I66, I67, I69, G45
Ischemic cerebrovascular disease	I63, I64, I65, I66, I67, G45
Hemorrhagic cerebrovascular disease	I60, I61, I62
Pancreatic cyst	K86.2
Pancreatic pseudocyst	K86.3
Acute pancreatitis	K85
Heart failure	I50, I11.0, I13.0, I13.2
Hyperuricemia	M10, E79
Gastrointestinal bleeding	K92.0, K92.1, K92.2
Liver cirrhosis/fibrosis	K70.3, K74
Alcoholic cirrhosis	K70.3
Pancreatic tumor	C24.102, C25, D13.6, D37.752, D37.703, D37.704
Malignant tumor of the pancreas	C25, C24.102
Malnutrition	E12, E40, E41, E42, E43, E44, E45, E46
Ulcer disease	K25, K26, K27, K28
Gastric ulcer	K25
Duodenal ulcer	K26
Osteoporosis	M80, M81
Inflammatory bowel disease	K50, K51
Crohn’s disease	K50
Ulcerative enteritis	K51

ICD: International Classification of Diseases.

Table 2 Demographics of chronic pancreatitis patients with a first diagnosis by calendar year

	2015	2016	2017	2018	2019	2020	2021	P value
Electronic records, n	3739	5760	7688	9488	9865	10383	11009	< 0.001
New case, n	3088	4334	5299	5945	5987	6475	6962	< 0.001
Mean hospitalizations per patient, n	1.21	1.16	1.19	1.20	1.17	1.16	1.15	0.097
Sex, %
Male	62.01	59.23	60.52	59.73	60.23	62.63	62.90	0.282
Female	37.99	40.77	39.48	40.27	39.77	37.37	37.10
Age, yr, mean ± SD	57.48 ± 15.78	58.01 ± 15.31	58.28 ± 15.59	58.84 ± 15.81	58.27 ± 15.77	57.52 ± 15.99	56.57 ± 16.57	0.387
Male	55.87 ± 15.35	56.58 ± 15.19	56.85 ± 15.17	57.37 ± 15.62	56.74 ± 15.38	56.10 ± 15.58	54.98 ± 16.41	0.415
Female	60.11 ± 16.12	60.09 ± 15.25	60.48 ± 15.96	61.01 ± 15.86	60.60 ± 16.06	59.88 ± 16.38	59.27 ± 16.51	0.389
Age group, %
0-14	0.39	0.35	0.51	0.64	0.33	0.34	0.39	0.902
15-64	64.57	63.99	63.37	60.52	61.78	63.83	64.97	0.820
≥ 65	35.04	35.65	36.12	38.84	37.88	35.83	34.65	0.807
Ethnicity, %
Han	94.36	94.78	95.32	95.31	94.27	94.18	95.17	0.722
Yi	1.33	1.80	1.91	1.55	2.04	2.12	2.08	0.515
Zang	1.69	2.03	1.83	2.27	2.24	2.30	1.74	0.923
Qiang	0.36	0.39	0.47	0.37	0.45	0.83	0.43	0.646
Other	2.27	0.99	0.47	0.50	1.00	0.57	0.57	0.007

Table 3 Prevalence of comorbidities in chronic pancreatitis patients

Diseases	Total cohort, n = 38090		Males, n = 23280		Females, n = 14810		P value
	n, %	Age, yr, mean ± SD	n, %	Age, yr, mean ± SD	n, %	Age, yr, mean ± SD
Total	100.00	57.58 ± 15.79	100.00	56.26 ± 15.25	100.00	59.99 ± 16.44	-
Diabetes	26.32	56.57 ± 14.60	28.94	55.43 ± 14.03	22.20	59.14 ± 15.51	< 0.001
Type I diabetes	0.79	45.33 ± 15.11	0.81	47.32 ± 12.81	0.76	42.23 ± 17.70	0.591
Type II diabetes	21.84	58.04 ± 14.26	23.73	56.78 ± 13.89	18.87	60.75 ± 14.66	< 0.001
Secondary diabetes	2.05	50.04 ± 13.24	2.71	49.35 ± 12.40	1.01	53.27 ± 16.27	< 0.001
Hypertension	21.51	66.32 ± 14.41	20.23	64.27 ± 14.43	23.51	69.36 ± 13.82	< 0.001
Cholelithiasis	16.79	62.33 ± 16.14	14.95	60.23 ± 15.37	19.67	64.90 ± 16.68	< 0.001
Dyslipidemia	16.70	51.49 ± 14.28	16.76	48.57 ± 13.12	16.61	56.01 ± 14.81	0.708
Cerebrovascular disease	12.76	69.75 ± 13.34	12.19	68.52 ± 13.55	13.65	71.60 ± 12.79	< 0.001
Ischemic cerebrovascular disease	11.75	69.55 ± 13.38	11.17	68.54 ± 13.57	12.65	71.09 ± 12.92	< 0.001
Hemorrhagic cerebrovascular disease	0.34	64.05 ± 14.42	0.43	62.63 ± 14.55	0.20	69.39 ± 12.79	< 0.001
Fatty liver disease	12.39	49.53 ± 13.50	13.46	47.20 ± 12.63	10.72	54.28 ± 13.96	< 0.001
Alcoholic fatty liver disease	0.35	54.07 ± 12.45	0.53	54.32 ± 12.38	0.07	50.50 ± 13.39	< 0.001
Coronary heart disease	10.07	72.15 ± 12.77	8.37	71.13 ± 13.10	12.75	73.27 ± 12.31	< 0.001
Heart failure	5.27	74.15 ± 13.38	4.72	72.62 ± 13.98	6.14	76.06 ± 12.33	< 0.001
Acute pancreatitis	5.08	51.38 ± 15.68	6.35	52.17 ± 14.18	3.07	48.80 ± 19.57	< 0.001
Hyperuricemia	4.93	56.86 ± 17.25	6.42	55.07 ± 16.87	2.59	64.28 ± 16.85	< 0.001
Ulcer disease	4.68	60.16 ± 14.54	5.28	59.30 ± 14.06	3.73	62.22 ± 15.46	< 0.001
Gastric ulcer	2.17	60.34 ± 13.91	2.40	59.36 ± 13.34	1.80	62.60 ± 14.92	< 0.001
Duodenal ulcer	1.30	59.15 ± 14.46	1.65	58.53 ± 14.65	0.74	61.28 ± 13.62	< 0.001
Liver cirrhosis/fibrosis	3.49	58.70 ± 13.92	4.35	57.05 ± 13.12	2.13	65.09 ± 15.04	< 0.001
Alcoholic cirrhosis	0.72	53.23 ± 10.21	1.15	53.31 ± 10.19	0.05	49.60 ± 10.54	< 0.001
Pancreatic pseudocyst	3.45	52.55 ± 14.28	4.46	51.57 ± 12.92	1.85	56.38 ± 18.17	< 0.001
Malnutrition	3.36	64.04 ± 16.53	3.80	62.74 ± 15.52	2.67	66.86 ± 18.23	< 0.001
Gastrointestinal bleeding	2.93	61.76 ± 16.38	3.46	59.78 ± 15.84	2.10	67.13 ± 16.64	< 0.001
Pancreatic tumor	2.65	61.43 ± 12.13	2.97	61.27 ± 11.77	2.15	61.79 ± 12.89	< 0.001
Malignant tumor of pancreas	2.36	61.74 ± 11.99	2.64	61.50 ± 11.67	1.91	62.27 ± 12.65	< 0.001
Osteoporosis	2.03	75.28 ± 13.19	1.37	70.13 ± 13.89	3.06	78.02 ± 11.94	< 0.001
Inflammatory bowel disease	0.14	56.13 ± 15.76	0.13	56.75 ± 14.03	0.17	55.43 ± 17.76	0.388
Crohn’s disease	0.03	56.40 ± 14.07	0.03	58.67 ± 10.76	0.03	53.00 ± 19.37	1
Ulcerative enteritis	0.12	56.00 ± 16.05	0.11	56.15 ± 14.56	0.14	55.83 ± 17.90	0.429

Table 4 Available studies on comorbidities of chronic pancreatitis

Region	Study design	Study period	Total CP patients	Frequent comorbidities compared with controls	Ref.
Denmark	Nationwide retrospective cohort study	1995-2010	11972	Cerebrovascular disease, chronic pulmonary disease, ulcer disease, diabetes, chronic renal disease, and pancreatic cancer	[4]
United States and Denmark	Cross-sectional, multicenter prospective study	Not available	171	Anxiety and depression	[40]
United States	Retrospective cohort study	2015-2020	63230	Hypertension, diabetes, and myocardial Infarction	[41]
United States	Ongoing longitudinal cohort study	2017-2022	488	Depression, anxiety, sleep disturbance, and physical disability	[42]
United States	Cohort study (NAPS2 cohort)	2000-2014	1024	Gallstones, diabetes, heart disease/heart attack/stroke, liver disease, renal disease, or prior history of cancer	[25]
United Kingdom	Cohort Study (the United Kingdom BioBank cohort)	2000-2020	1027	Gallstones, hyperlipidemia, diabetes, hypertriglyceridemia, hypercalcemia, pancreatic cancer, celiac, and ulcerative colitis	[13]
Canada	Retrospective study	2007-2014	75744	Anxiety and depression	[43]
China	Population-based cohort study	2000-2011	15848	Urolithiasis	[44]
China	Population-based cohort study	2000-2011	17810	Subsequent pyogenic liver abscess	[45]
China	Population-based cohort study	2000-2011	16672	Cerebrovascular disease	[46]
China	Population-based cohort study	2000-2011	17778	Deep vein thrombosis and pulmonary embolism	[20]
China	Population-based cohort study	2000-2011	17796	Inflammatory bowel disease	[47]
China	Prospective observational study	2019-2021	720	Anxiety and depression	[48]