Relationship of serum pancreatic enzyme testing trends with the diagnosis of acute pancreatitis.

Objective: The reasons for increasing incidence of acute pancreatitis (AP) are not completely understood. We hypothesized that the rate of serum pancreatic enzyme (PE) testing is increasing, and it correlates with AP diagnosis.

Methods: We retrieved electronic patient data for all emergency department visits at 2 University of Pittsburgh Medical Center hospitals (UPMC Presbyterian [PUH] from 1996 to 2005, N = 422,745; UPMC St Margaret Hospital [SMH] from 1999 to 2005, N = 202,171). We evaluated the trends for serum PE testing (amylase, lipase, or both) and correlated this with the proportion of visits resulting in an inpatient discharge diagnosis of AP.

Results: Serum PE testing increased significantly from 4.6% (95% CI, 4.4-4.9) in 1996 to 9.5% (95% CI, 9.3-9.7) in 2005. On multivariate modeling, the rates for serum PE testing were higher at SMH (vs PUH: OR, 1.53; 95% CI, 1.50-1.57), among females (vs males: OR, 1.30 [95% CI, 1.28-1.33]), and increased with age (OR, 1.06 [95% CI, 1.05-1.06] for each 10 years). The proportion of ED visits resulting in an inpatient discharge diagnosis of AP increased significantly during the study period and correlated highly with the rate of PE testing.

Conclusions: The rate of serum PE testing is increasing. Increased serum PE testing may be contributing to the increase in the incidence of AP.