Shaka Hafeez, Asotibe Jennifer C, Achebe Ikechukwu, Pudasaini Garima
Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA.
Cureus. 2020 Sep 10;12(9):e10351. doi: 10.7759/cureus.10351.
Introduction Hypertriglyceridemia (HTG)-induced pancreatitis is the third most common cause of acute pancreatitis after gallstone disease and alcohol. We analyzed data from the National (Nationwide) Inpatient Sample (NIS) with the aim of evaluating the outcomes of patients with HTG-induced pancreatitis when compared to those with biliary-induced pancreatitis. Methods The NIS database was sourced for data involving adult hospitalizations for HTG-induced pancreatitis in the United States between January 1, 2016 and December 31, 2017. The main outcome was mortality in patients with biliary pancreatitis vs HTG pancreatitis. Secondary outcomes were the incidence of sepsis, septic shock, non-ST-elevation myocardial infarction (NSTEMI), blood transfusion requirements, acute kidney failure, acute respiratory distress syndrome (ARDS), and length of hospital stay. Results A total of 575,230 patients were admitted with a diagnosis of acute pancreatitis, 18.2% of which were classified as having HTG pancreatitis. The in-hospital mortality for pancreatitis was 0.59%. Patients with HTG pancreatitis had lower odds of in-hospital mortality (adjusted odds ratio [aOR]: 0.74, 95% CI 0.582-0.934, p=0.012) compared to those with biliary pancreatitis. Patients with HTG pancreatitis had less odds of developing comorbid sepsis (aOR: 0.52, 95% CI 0.441-0.612, p<0.001), septic shock (aOR: 0.64, 95% CI 0.482-0.851, p<0.001), and NSTEMI (aOR: 0.70, 95% CI 0.535-0.926, p<0.001) and had less odds of requiring transfusion of blood products (aOR: 0.57, 95% CI 0.478-0.678, p<0.001) when compared to those with biliary pancreatitis. Patients with HTG pancreatitis also had a lower average length of hospital stay and lower total hospital charges compared to those with biliary pancreatitis. There was no statistical difference, however, in acute kidney failure and ARDS between the two groups. Conclusion Patients with HTG-induced pancreatitis possibly have better inpatient outcomes including mortality when compared to those with biliary-induced pancreatitis.
引言 高甘油三酯血症（HTG）诱发的胰腺炎是继胆结石病和酒精之后急性胰腺炎的第三大常见病因。我们分析了来自国家（全国）住院患者样本（NIS）的数据，旨在评估HTG诱发的胰腺炎患者与胆源性胰腺炎患者相比的预后情况。方法 从NIS数据库中获取2016年1月1日至2017年12月31日期间美国因HTG诱发的胰腺炎而住院的成年患者的数据。主要结局是胆源性胰腺炎患者与HTG胰腺炎患者的死亡率。次要结局包括脓毒症、感染性休克、非ST段抬高型心肌梗死（NSTEMI）的发生率、输血需求、急性肾衰竭、急性呼吸窘迫综合征（ARDS）以及住院时间。结果 共有575230例患者被诊断为急性胰腺炎入院，其中18.2%被归类为患有HTG胰腺炎。胰腺炎患者的院内死亡率为0.59%。与胆源性胰腺炎患者相比，HTG胰腺炎患者的院内死亡几率较低（调整后的优势比[aOR]：0.74，95%置信区间0.582 - 0.934，p = 0.012）。与胆源性胰腺炎患者相比，HTG胰腺炎患者发生合并脓毒症（aOR：0.52，95%置信区间0.441 - 0.612，p < 0.001）、感染性休克（aOR：0.64，95%置信区间0.482 - 0.851，p < 0.001）和NSTEMI（aOR：0.70，95%置信区间0.535 - 0.926，p < 0.001）的几率较低，且需要输注血液制品的几率也较低（aOR：0.57，95%置信区间0.478 - 0.678，p < 0.001）。与胆源性胰腺炎患者相比，HTG胰腺炎患者的平均住院时间也较短，住院总费用也较低。然而，两组之间在急性肾衰竭和ARDS方面没有统计学差异。结论 与胆源性胰腺炎患者相比，HTG诱发的胰腺炎患者可能具有更好的住院结局，包括死亡率。
