Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon.
Arab J Gastroenterol. 2020 Jun;21(2):106-110. doi: 10.1016/j.ajg.2020.04.015. Epub 2020 May 12.
To determine the aetiology, hospital course, and outcome of patients diagnosed with acute pancreatitis (AP) presenting to the Emergency Department (ED) of a tertiary care center in Lebanon.
Using a retrospective cross-sectional study design, records of all patients presenting to the ED with elevated lipase over one calendar year (2016) were reviewed. Patients diagnosed with AP according to the revised Atlanta classification were identified.
Over one year, a total of 24,133 adult patients visited the ED and 4,976 had serum lipase determination. Of those, 75 patients (mean age 59.4 ± 16.1; range 20-95; M:F 2.1) had confirmed AP accounting for 0.3% of adult ED visits. The most common etiologies were biliary (36%), idiopathic (16%), drugs (13%), and alcohol (11%). Intake of drugs known to be associated with AP was identified in 26% of patients. Alcoholic pancreatitis was more common in males, while biliary pancreatitis was more common in females (p less than 0.05 in both). 63 patients (84%) required regular hospital admission and only 1 (1.3%) required intensive care unit admission and passed away after multiorgan failure. Mean hospital stay was 4.0 ± 4.0 days (range 0-23) with mean hospital charges of $6,637 ± 8,496.
Acute pancreatitis accounts for a relatively small number of emergency visits in Lebanon. Leading etiologies are biliary and drugs, with a low contribution of alcohol compared to the West. The economic burden of AP is important, but outcomes appear largely favorable with an overall mortality of less than 2%.
确定在黎巴嫩一家三级护理中心的急诊科（ED）就诊的急性胰腺炎（AP）患者的病因、住院过程和结局。
使用回顾性横断面研究设计，回顾了一年中所有因血清脂肪酶升高而到 ED 就诊的患者记录。根据修订后的亚特兰大分类标准，确定了符合 AP 诊断的患者。
在一年中，共有 24133 名成年患者到 ED 就诊，其中 4976 人进行了血清脂肪酶测定。其中，75 名患者（平均年龄 59.4 ± 16.1；范围 20-95；男：女 2.1）确诊为 AP，占成年 ED 就诊患者的 0.3%。最常见的病因是胆源性（36%）、特发性（16%）、药物相关性（13%）和酒精性（11%）。在 26%的患者中发现了与 AP 相关的药物摄入史。酒精性胰腺炎在男性中更为常见，而胆源性胰腺炎在女性中更为常见（两者均 p < 0.05）。63 名（84%）患者需要常规住院治疗，只有 1 名（1.3%）患者需要入住重症监护病房，因多器官功能衰竭去世。平均住院时间为 4.0 ± 4.0 天（范围 0-23），平均住院费用为 6637 ± 8496 美元。
急性胰腺炎在黎巴嫩的急诊就诊中占比较小。主要病因是胆源性和药物相关性，与西方相比，酒精的贡献较低。AP 的经济负担很重要，但总体预后良好，死亡率低于 2%。
