Adamo Karin, Sandblom Gabriel, Brännström Fredrik, Strigård Karin
Department of Surgical and Perioperative Science, Umeå University, 901 85, Umeå, Sweden.
Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Int J Colorectal Dis. 2016 Mar;31(3):669-73. doi: 10.1007/s00384-015-2500-7. Epub 2016 Jan 14.
The aim of this study was to assess the impact of diabetes mellitus, Crohn's disease, HIV/aids, and obesity on the prevalence and readmission rate of perianal abscess.
The study cohort was based on the Swedish National Patient Register and included all patients treated for perianal abscess in Sweden 1997-2009. The prevalence and risk for readmission were assessed in association with four comorbidity diagnoses: diabetes mellitus, Crohn's disease, HIV, and/or AIDS and obesity.
A total of 18,877 patients were admitted during the study period including 11,138 men and 4557 women (2.4:1). Crohn's disease, diabetes, and obesity were associated with a significantly higher prevalence of perianal abscess than an age- and gender-matched background population (p < 0.05). In univariate analysis, neither age nor gender had any significant impact on the risk for readmission. In a multivariate Cox proportional hazard analysis, Crohns disease was the only significant risk factor for readmission of perianal abscess.
Crohn's disease, diabetes, and obesity increase the risk for perianal abscess. Of these, Crohn's and HIV has an impact on readmission. The pathogenesis and the influence of diabetes and obesity need further research if we are to understand why these diseases increase the risk for perianal abscess but not its recurrence.
本研究旨在评估糖尿病、克罗恩病、艾滋病毒/艾滋病和肥胖对肛周脓肿患病率和再入院率的影响。
研究队列基于瑞典国家患者登记册，纳入了1997年至2009年在瑞典接受肛周脓肿治疗的所有患者。与四种合并症诊断相关评估了肛周脓肿的患病率和再入院风险，这四种合并症诊断为：糖尿病、克罗恩病、艾滋病毒和/或艾滋病以及肥胖。
在研究期间共收治了18877例患者，其中男性11138例，女性4557例（比例为2.4:1）。与年龄和性别匹配的背景人群相比，克罗恩病、糖尿病和肥胖与肛周脓肿的患病率显著更高相关（p < 0.05）。在单因素分析中，年龄和性别对再入院风险均无显著影响。在多因素Cox比例风险分析中，克罗恩病是肛周脓肿再入院的唯一显著风险因素。
克罗恩病、糖尿病和肥胖会增加肛周脓肿的风险。其中，克罗恩病和艾滋病毒会影响再入院率。如果我们要理解为什么这些疾病会增加肛周脓肿的风险但不影响其复发，糖尿病和肥胖的发病机制及其影响需要进一步研究。
