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腹腔疾病相关的急性胰腺炎:住院率是否发生变化,且与更差的结局相关?

Acute Pancreatitis in Celiac Disease: Has the Inpatient Prevalence Changed and Is It Associated With Worse Outcomes?

机构信息

From the Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY.

Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.

出版信息

Pancreas. 2020 Oct;49(9):1202-1206. doi: 10.1097/MPA.0000000000001657.

Abstract

OBJECTIVES

Studies suggest that adults diagnosed with celiac disease (CD) are at higher risk of developing acute pancreatitis (AP). The aim of this study is to explore the relationship between CD and AP in terms of inpatient prevalence, mortality, morbidity, and resource utilization in the past decade.

METHODS

Retrospective cohort study using the Nationwide Inpatient Sample (2007-2016). The primary outcome was the occurrence of AP in CD patients. Secondary outcomes were the trend in AP cases in CD patients, and mortality, morbidity, length of stay, and total hospital charges and costs.

RESULTS

Of 337,201 CD patients identified, 7372 also had AP. The mean age was 53 years, 71% were women. The inpatient prevalence of AP in CD was 2.2% versus 1.2% in non-CD cohort (P < 0.01). Patients with CD displayed increased odds of having AP (adjusted odds ratio, 1.92; P < 0.01). Patients with AP and CD displayed lower odds of morbidity and mortality than non-CD patients with AP.

CONCLUSIONS

The inpatient prevalence of AP is higher in CD patients, and increased from 2007 to 2016. Patients with CD and AP displayed lower morbidity and mortality, which may suggest that they have a less severe form of AP or lower baseline comorbidity.

摘要

目的

研究表明,被诊断为乳糜泻 (CD) 的成年人患急性胰腺炎 (AP) 的风险更高。本研究旨在探讨过去十年中 CD 与 AP 在住院患病率、死亡率、发病率和资源利用方面的关系。

方法

使用全国住院患者样本(2007-2016 年)进行回顾性队列研究。主要结局是 CD 患者中发生 AP 的情况。次要结局是 CD 患者中 AP 病例的趋势,以及死亡率、发病率、住院时间、总住院费用和成本。

结果

在确定的 337201 例 CD 患者中,有 7372 例同时患有 AP。平均年龄为 53 岁,71%为女性。与非 CD 队列(1.2%)相比,CD 患者中 AP 的住院患病率为 2.2%(P < 0.01)。患有 CD 的患者发生 AP 的可能性更高(调整后的优势比,1.92;P < 0.01)。患有 AP 和 CD 的患者的发病率和死亡率低于非 CD 患者。

结论

AP 在 CD 患者中的住院患病率较高,且从 2007 年到 2016 年呈上升趋势。患有 CD 和 AP 的患者发病率和死亡率较低,这可能表明他们患有较轻的 AP 或较低的基线合并症。

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