Frey Charles F, Zhou Hong, Harvey Danielle J, White Richard H
Department of Surgery, UC Davis Medical Center, Sacramento, CA, USA.
Pancreas. 2006 Nov;33(4):336-44. doi: 10.1097/01.mpa.0000236727.16370.99.
To better define the epidemiology of acute pancreatitis in a racially diverse population.
Analysis of all patients hospitalized in California with first-time acute pancreatitis for the period between January 1994 and September 2001. Subtypes were classified based on the presence or absence of predisposing conditions.
There were 70,231 patients hospitalized for first-time acute pancreatitis; 32.6% had biliary tract disease alone, 20.3% had alcohol abuse alone, and 36.6% were idiopathic. The age-standardized incidence increased by 32% from 33.2 to 43.8 cases per 100,000 adults for the period between 1994 and 2001, with the largest increase in the biliary group (52%). The standardized incidence rate of alcoholic and idiopathic pancreatitis was highest in African Americans, whereas biliary pancreatitis was highest in Hispanics. There was no change over time in the percentage of patients dying in the first 14 or 91 days; and in a risk-adjusted model, patients with alcoholic pancreatitis had the highest risk of dying.
The incidence rate of acute pancreatitis rose for the period between 1994 and 2001. However, there was no reduction in the 14- or 91-day case-fatality rate. Further research is needed to explain both the rise in the incidence rate of pancreatitis and the absence of any improvement in the early case-fatality rate.
在种族多样化人群中更好地明确急性胰腺炎的流行病学特征。
对1994年1月至2001年9月期间在加利福尼亚州首次因急性胰腺炎住院的所有患者进行分析。根据是否存在诱发因素对亚型进行分类。
共有70231例患者因首次急性胰腺炎住院；仅患有胆道疾病的患者占32.6%，仅酗酒的患者占20.3%，特发性患者占36.6%。1994年至2001年期间，年龄标准化发病率从每10万成年人33.2例增加到43.8例，增长了32%，其中胆道疾病组增长幅度最大（52%）。非裔美国人中酒精性和特发性胰腺炎的标准化发病率最高，而西班牙裔中胆源性胰腺炎的标准化发病率最高。患者在最初14天或91天内死亡的百分比随时间没有变化；在风险调整模型中，酒精性胰腺炎患者的死亡风险最高。
1994年至2001年期间急性胰腺炎的发病率有所上升。然而，14天或91天的病死率并未降低。需要进一步研究来解释胰腺炎发病率上升以及早期病死率未得到任何改善的原因。
