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妊娠期和产褥期急性胰腺炎:发生率、危险因素和预后。

Acute Pancreatitis During and After Pregnancy: Incidence, Risk Factors, and Prognosis.

机构信息

Dipartimento Medicina, ARNAS Ospedale Civico, Piazza Nicola Leotta 4, 90127, Palermo, Italy.

Dipartimento per le Attività Sanitarie ed Osservatorio Epidemiologico, Regione Sicilia, Via Vaccaro, 5, 90145, Palermo, Italy.

出版信息

Dig Dis Sci. 2021 Sep;66(9):3164-3170. doi: 10.1007/s10620-020-06608-5. Epub 2020 Oct 21.

Abstract

BACKGROUND

Acute pancreatitis may complicate pregnancy and both are associated with gallstones, but its incidence is not well known.

AIMS

To validate hospital discharge records in diagnosing acute pancreatitis and gallstones and to evaluate acute pancreatitis incidence in non pregnant, pregnant and after delivery using hospital discharge records METHODS: We identified all hospital discharge records of hospitalized Sicilian women of childbearing age (2011-2016). We determined agreement between 300 hospital discharge records and hospital records in diagnosing acute pancreatitis and gallstones. Acute pancreatitis incidence, prognosis, and their relationship with age and gallstones were calculated in the three groups using hospital discharge records.

RESULTS

There was 92% and 88% agreement in diagnosing acute pancreatitis and gallstones between hospital discharge and hospital records. In non pregnant, 1,564 of 7,236,863 women-years (21.61/100,000 person-years) developed acute pancreatitis. During pregnancy, 34 of 226,492 women-years developed acute pancreatitis (20.02/100,000 person-years). Postpartum acute pancreatitis incidence was higher than non pregnant, only in the first 2 years with the peak in the first semester (95.4/100,000 person-years). The increased incidence of postpartum acute pancreatitis was associated with gallstones in youngest women (gallstones acute pancreatitis in women below 20 years old versus non pregnant: rate ratios 16.61; 95% CI 8.40-32.87).

CONCLUSIONS

Agreement in acute pancreatitis and gallstones diagnosis between hospital discharge and hospital records was accurate. Acute pancreatitis incidence was increased only in the first 2 years after delivery in young women with gallstones.

摘要

背景

急性胰腺炎可能会并发妊娠,且两者均与胆石症有关,但具体发病率尚不清楚。

目的

验证住院记录在诊断急性胰腺炎和胆石症方面的准确性,并使用住院记录评估非妊娠、妊娠和产后时急性胰腺炎的发病率。

方法

我们确定了所有住院的西西里育龄妇女(2011-2016 年)的住院记录。我们比较了 300 份住院记录与住院病历在诊断急性胰腺炎和胆石症方面的一致性。使用住院记录计算了三组人群中急性胰腺炎的发病率、预后及其与年龄和胆石症的关系。

结果

住院记录和住院病历在诊断急性胰腺炎和胆石症方面的一致性分别为 92%和 88%。在非妊娠人群中,7236836 名妇女年中有 1564 人(21.61/100000 人年)发生急性胰腺炎。在妊娠人群中,226492 名妇女年中有 34 人(20.02/100000 人年)发生急性胰腺炎。产后急性胰腺炎的发病率高于非妊娠人群,但仅在前 2 年且高峰出现在第 1 个半年(95.4/100000 人年)。产后急性胰腺炎发病率的增加与年轻女性的胆石症有关(20 岁以下女性胆石症急性胰腺炎与非妊娠相比:发病率比 16.61;95%可信区间 8.40-32.87)。

结论

住院记录和住院病历在诊断急性胰腺炎和胆石症方面的一致性准确。在有胆石症的年轻女性中,产后仅在前 2 年急性胰腺炎的发病率增加。

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