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荷兰慢性胰腺炎登记处(CARE):全国性前瞻性评估与随访的设计与基本原理

Dutch Chronic Pancreatitis Registry (CARE): design and rationale of a nationwide prospective evaluation and follow-up.

作者信息

Ahmed Ali U, Issa Y, van Goor H, van Eijck C H, Nieuwenhuijs V B, Keulemans Y, Fockens P, Busch O R, Drenth J P, Dejong C H, van Dullemen H M, van Hooft J E, Siersema P D, Spanier B W M, Poley J W, Poen A C, Timmer R, Seerden T, Tan A C, Thijs W J, Witteman B J M, Romkens T E H, Roeterdink A J, Gooszen H G, van Santvoort H C, Bruno M J, Boermeester M A

机构信息

Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands; Department of Surgery, University Medical Center Utrecht, Utrecht, Netherlands.

Department of Surgery, Academic Medical Center Amsterdam, Amsterdam, Netherlands.

出版信息

Pancreatology. 2015 Jan-Feb;15(1):46-52. doi: 10.1016/j.pan.2014.11.002. Epub 2014 Nov 29.

Abstract

BACKGROUND

Chronic pancreatitis is a complex disease with many unanswered questions regarding the natural history and therapy. Prospective longitudinal studies with long-term follow-up are warranted.

METHODS

The Dutch Chronic Pancreatitis Registry (CARE) is a nationwide registry aimed at prospective evaluation and follow-up of patients with chronic pancreatitis. All patients with (suspected) chronic or recurrent pancreatitis are eligible for CARE. Patients are followed-up by yearly questionnaires and review of medical records. Study outcomes are pain, disease complications, quality of life, and pancreatic function. The target sample size was set at 500 for the first year and 1000 patients within 3 years.

RESULTS

A total of 1218 patients were included from February 2010 until June 2013 by 76 participating surgeons and gastroenterologist from 33 hospitals. Participation rate was 90% of eligible patients. Eight academic centers included 761 (62%) patients, while 25 community hospitals included 457 (38%). Patient centered outcomes were assessed by yearly questionnaires, which had a response rate of 85 and 82% for year 1 and 2, respectively. The median age of patients was 58 years, 814 (67%) were male, and 38% had symptoms for less than 5 years.

DISCUSSION

The CARE registry has successfully recruited over 1200 patients with chronic and recurrent pancreatitis in about 3 years. The defined inclusion criteria ensure patients are included at an early disease stage. Participation and compliance rates are high. CARE offers a unique opportunity with sufficient power to investigate many clinical questions regarding natural course, complications, and efficacy and timing of treatment strategies.

摘要

背景

慢性胰腺炎是一种复杂的疾病,在自然病史和治疗方面存在许多未解决的问题。有必要进行长期随访的前瞻性纵向研究。

方法

荷兰慢性胰腺炎登记处(CARE)是一个全国性登记处,旨在对慢性胰腺炎患者进行前瞻性评估和随访。所有(疑似)慢性或复发性胰腺炎患者均符合CARE的条件。通过每年的问卷调查和病历审查对患者进行随访。研究结果包括疼痛、疾病并发症、生活质量和胰腺功能。第一年的目标样本量设定为500例,3年内达到1000例患者。

结果

2010年2月至2013年6月,来自33家医院的76名参与研究的外科医生和胃肠病学家共纳入了1218例患者。参与率为符合条件患者的90%。8个学术中心纳入了761例(62%)患者,而25家社区医院纳入了457例(38%)。通过每年的问卷调查评估以患者为中心的结果,第1年和第2年的回复率分别为85%和82%。患者的中位年龄为58岁,814例(67%)为男性,38%的患者症状出现时间少于5年。

讨论

CARE登记处在约3年内成功招募了1200多名慢性和复发性胰腺炎患者。明确的纳入标准确保患者在疾病早期被纳入。参与率和依从率都很高。CARE提供了一个独特的机会,有足够的能力来研究许多关于自然病程、并发症以及治疗策略的疗效和时机等临床问题。

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