Mortality, malignancy, and comorbidities associated with chronic pancreatitis: a Nationwide Database study in Taiwan

Purpose: This study aimed to investigate the risk of death, malignancy, and comorbidities in patients with chronic pancreatitis (CP). Methods & Materials: We conducted a nationwide retrospective matched-cohort study using data from Taiwan's National Health Insurance Research Database (NHIRD) collected between 2000 and 2011. The CP was defined if patients had at least one admission diagnosis or more than three outpatient clinic visits within a year with ICD-9-CM code 577.1. Each CP case was compared with 10 age-, sex- and index year-matched controls without CP, who were randomly selected from the whole claims data of the NHIRD set. Next, the incidence rate ratio (IRR) based on Poisson regression analysis of mortality, malignancy, and comorbidities were compared between the CP cohort and the non-CP cohort. Results: During the study period, 12,605 persons (76.8% men) with CP were identified and matched with 126,050 controls with a mean age ± standard deviation of 48.4 ± 14.5 years. The incidence rate of peptic ulcer disease, liver disease, diabetes, and hyperlipidemia were statistically higher in the CP cohort than that in the non-CP cohort. Twenty percent of the CP group died during the follow-up period, compared with 7.7% of the non-CP group, corresponding to the incidence of death in the CP cohort was 41 per 1,000 person-years, and compared with the non-CP cohort, the IRR was 2.84 [95% confidence interval: 2.724 – 2.961] (P < 0.001). Malignancy was a frequent cause of death in the CP group (IRR per 1,000 person-years: 4.1) and non-CP group (IRR per 1,000 person-years: 2.4). The incidence rate of malignancy in the CP group and the control group was 13.8 and 9.9 per 1,000 person-years, respectively (P < 0.001). Conclusion: The nationwide matched-cohort database study in Taiwan revealed that patients with CP have a higher risk of death from malignancy and a higher incidence of comorbidities than the general population without CP. This study was supported by grants from the Ministry of Science and Technology, Taiwan (MOST 107-2634-F-002-015 and 106-2628-E-002-004-MY3).