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基于人群的急性胰腺炎首次住院后再入院评估。

A population-based evaluation of readmissions after first hospitalization for acute pancreatitis.

机构信息

From the *University of Pittsburgh Medical Center, and †University of Pittsburgh School of Medicine, Pittsburgh, PA.

出版信息

Pancreas. 2014 May;43(4):630-7. doi: 10.1097/MPA.0000000000000078.

Abstract

OBJECTIVE

This study aimed to evaluate the burden and pattern of pancreatitis-related readmissions after index hospitalization for acute pancreatitis (AP).

METHODS

We identified all unique white or black Allegheny County residents with first hospital admission for AP from 1996 to 2005 using the Pennsylvania Health Care Cost Containment Council data set. The final study population consisted of patients (n = 6010) who survived index admission and had follow-up data on readmissions. The etiology was determined using associated diagnosis codes. We analyzed pancreatitis-related readmissions until the third quarter of 2007 (median follow-up time, 39 months).

RESULTS

The absolute risk and total burden of readmissions were 21.9% and 2947 for primary AP, respectively, 5.8% and 812 for primary chronic pancreatitis (CP), respectively, and 32.3% and 6612 for any pancreatitis diagnosis, respectively. Patients with alcohol etiology (etiology on index admission in 20.3%; responsible for 41.6%-50.4% readmissions) and subsequent diagnosis of CP (any CP diagnosis, 12.8%; responsible for 73% readmissions) accounted for a disproportionately higher fraction of readmissions. Readmission risk decreased with increasing age. A small fraction of patients accounted for most readmissions.

CONCLUSIONS

Readmission after AP is influenced by demographics, etiology, and subsequent CP diagnosis. Future studies should focus on understanding the factors driving readmissions in high-risk individuals to develop strategies for reducing pancreatitis-related readmissions and health care costs.

摘要

目的

本研究旨在评估急性胰腺炎(AP)指数住院后与胰腺炎相关的再入院负担和模式。

方法

我们使用宾夕法尼亚州医疗保健费用控制委员会数据集,确定了 1996 年至 2005 年期间所有初次住院因 AP 而住院的阿利根尼县白人或黑人唯一居民。最终研究人群包括存活指数入院并具有再入院随访数据的患者(n = 6010)。病因使用相关诊断代码确定。我们分析了直至 2007 年第三季度的胰腺炎相关再入院情况(中位随访时间为 39 个月)。

结果

原发性 AP 的绝对再入院风险和总负担分别为 21.9%和 2947,原发性慢性胰腺炎(CP)分别为 5.8%和 812,任何胰腺炎诊断分别为 32.3%和 6612。有酒精病因(指数入院时病因占 20.3%;占再入院的 41.6%-50.4%)和随后诊断为 CP(任何 CP 诊断,占 12.8%;占再入院的 73%)的患者占再入院的比例过高。再入院风险随年龄的增加而降低。一小部分患者占大多数再入院。

结论

AP 后的再入院受人口统计学、病因和随后的 CP 诊断的影响。未来的研究应重点关注了解导致高危人群再入院的因素,以制定减少胰腺炎相关再入院和医疗费用的策略。

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