Taguchi Masashi, Kubo Tatsuhiko, Yamamoto Mitsuyoshi, Muramatsu Keiji, Yasunaga Hideo, Horiguchi Hiromasa, Fujimori Kenji, Matsuda Shinya, Fushimi Kiyohide, Harada Masaru
From the *Third Department of Internal Medicine, and †Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu; ‡Department of Health Management and Policy, Graduate School of Medicine, University of Tokyo; §Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo; ∥Division of Medical Management, Hokkaido University Hospital, Sapporo; and ¶Department of Health Policy and Informatics, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Pancreas. 2014 Aug;43(6):863-6. doi: 10.1097/MPA.0000000000000137.
This study aimed to investigate the relationship between body mass index (BMI) and risk of death in patients with acute pancreatitis (AP) using a Japanese national administrative database.
We analyzed a total of 6002 patients with AP. We collected patient information, including sex, age, BMI, severity of AP based on the Japan Pancreas Society scoring system, and prognosis. We classified BMI into 5 categories (underweight [BMI, <18.5], normal range [18.5-24.9], preobese [25-29.9], obese class I [30-34.9], and obese class II/III [>35]) and investigated the relationship between each category and risk of death in AP.
There was a good correlation between the Japanese AP severity score and in-hospital mortality. Overall mortality of severe pancreatitis was 7.0% (n = 2245). Mortality in each BMI category was as follows: underweight, 6.4%; normal range, 3.6%; preobese, 2.4%; obese class I, 3.2%; and obese class II/III, 5.7%. Underweight and obese class II/III patients had significantly higher relative risk (RR) of death in AP compared with preobese patients after adjusting for sex, age, and severity of AP (RR, 2.7; 95% confidence interval, 1.6-4.5; and RR, 6.4; 95% confidence interval, 1.9-20.9, respectively).
Underweight or overweight was the independent risk factor for mortality in AP.
本研究旨在利用日本国家行政数据库调查急性胰腺炎（AP）患者的体重指数（BMI）与死亡风险之间的关系。
我们共分析了6002例AP患者。我们收集了患者信息，包括性别、年龄、BMI、基于日本胰腺学会评分系统的AP严重程度以及预后情况。我们将BMI分为5类（体重过轻[BMI，<18.5]、正常范围[18.5 - 24.9]、肥胖前期[25 - 29.9]、I级肥胖[30 - 34.9]以及II/III级肥胖[>35]），并研究了每一类与AP患者死亡风险之间的关系。
日本AP严重程度评分与院内死亡率之间存在良好的相关性。重症胰腺炎的总体死亡率为7.0%（n = 2245）。各BMI类别的死亡率如下：体重过轻，6.4%；正常范围，3.6%；肥胖前期，2.4%；I级肥胖，3.2%；II/III级肥胖，5.7%。在对性别、年龄和AP严重程度进行校正后，体重过轻和II/III级肥胖患者在AP中的死亡相对风险（RR）显著高于肥胖前期患者（RR分别为2.7；95%置信区间为1.6 - 4.5；以及RR为6.4；95%置信区间为1.9 - 20.9）。
体重过轻或超重是AP患者死亡的独立危险因素。
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