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与急性胰腺炎相关的住院治疗趋势及结果:2001年至2014年美国的流行病学情况

Trends and Outcomes of Hospitalizations Related to Acute Pancreatitis: Epidemiology From 2001 to 2014 in the United States.

作者信息

Gapp Jonathan, Hall Alexander G, Walters Ryan W, Jahann Darius, Kassim Thamer, Reddymasu Savio

机构信息

Biostatistics Core Facility and.

Division of Internal Medicine, Department of Medicine, Creighton University.

出版信息

Pancreas. 2019 Apr;48(4):548-554. doi: 10.1097/MPA.0000000000001275.

Abstract

OBJECTIVES

The aim of this study was to determine the recent trends of the rates of hospitalization, mortality of hospitalized patients, and associated health care utilization in patients with acute pancreatitis (AP).

METHODS

We identified adult patients with primary discharge diagnosis of AP from the National Inpatient Sample database. Patients with chronic pancreatitis and/or pancreatic cancer were excluded. Primary outcomes included age-adjusted incidence of AP and in-hospital mortality based on US standard population derived from the 2000 census data. Secondary outcomes were length of stay, inflation-adjusted hospital costs in 2014 US dollars, and procedural rates. Subgroup analysis included disease etiologies, age, race, sex, hospital region, hospital size, and institution type.

RESULTS

From 2001 to 2014, the rate of primary discharge diagnosis for AP increased from 65.38 to 81.88 per 100,000 US adults per year. In-hospital case fatality decreased from 1.68% to 0.69%. Mortality rate is higher in patients with AP who are older than 65 years (3.4%). Length of stay decreased, with a median of 3.8 days; cost per hospitalization decreased since 2007 from $7602 to $6766 in 2014.

CONCLUSIONS

The rate of hospitalization related to AP in the United States continues to increase. Mortality, length of stay, and cost per hospitalization decrease. The increase in volume of hospitalization might contribute to an overall increase in health care resource utilization.

摘要

目的

本研究旨在确定急性胰腺炎(AP)患者的住院率、住院患者死亡率及相关医疗保健利用率的近期趋势。

方法

我们从国家住院患者样本数据库中识别出以AP为主要出院诊断的成年患者。排除患有慢性胰腺炎和/或胰腺癌的患者。主要结局包括基于2000年人口普查数据得出的美国标准人群的AP年龄调整发病率和住院死亡率。次要结局为住院时间、以2014年美元计算的经通胀调整的住院费用以及手术率。亚组分析包括疾病病因、年龄、种族、性别、医院地区、医院规模和机构类型。

结果

从2001年到2014年,AP的主要出院诊断率从每年每10万美国成年人65.38例增至81.88例。住院病死率从1.68%降至0.69%。65岁以上的AP患者死亡率更高(3.4%)。住院时间缩短,中位数为3.8天;自2007年以来,每次住院费用从7602美元降至2014年的6766美元。

结论

美国与AP相关的住院率持续上升。死亡率、住院时间和每次住院费用下降。住院量的增加可能导致医疗保健资源利用率总体上升。

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