Department of General Surgery, Northland District Health Board, Whangarei, New Zealand.
Department of General Surgery, University of Auckland, Auckland, New Zealand.
ANZ J Surg. 2021 Jul;91(7-8):1558-1562. doi: 10.1111/ans.16839. Epub 2021 Apr 6.
Previous studies have demonstrated a high incidence of acute pancreatitis (AP) in New Zealand, with Maori having the highest reported incidence worldwide. It is possible that barriers to healthcare exist for rural and Maori patients, leading to poorer outcomes. The aim of this study is to compare differences in severity and outcomes in patients with AP with regards to rurality and ethnicity.
Multicentre retrospective study of all adults aged >16 years who were admitted to any hospital with AP in Northland between 1 January 2014 and 31 December 2018 was performed. Pancreatitis severity was classified using the Revised Atlanta classification. The primary outcome of interest was the difference in severity of pancreatitis with regards to rurality and ethnicity. Secondary outcomes of interest included clinical outcomes, aetiology of AP and re-presentation rates.
A total of 468 patients were included. There was no difference found between rural and urban or Maori and non-Maori patients with regards to disease severity, length of stay, mortality or intensive care unit admission rate. A significant difference in aetiology was found between Maori and non-Maori patients, with a higher rate of gallstone pancreatitis in Maori. There was no difference in local complications or number of re-presentations between groups.
This study showed no difference in the severity or outcomes of AP across rural and urban patients in the Northland region of New Zealand. Secondary outcomes were broadly comparable between groups, with a higher rate of gallstone pancreatitis found in Maori compared to non-Maori.
先前的研究表明，新西兰的急性胰腺炎（AP）发病率很高，毛利人报告的发病率居世界首位。农村和毛利患者可能存在医疗保健障碍，导致预后较差。本研究旨在比较农村和种族差异对 AP 患者严重程度和结局的影响。
对 2014 年 1 月 1 日至 2018 年 12 月 31 日期间在北地医院因 AP 住院的所有>16 岁的成年人进行了多中心回顾性研究。采用修订亚特兰大分类法对胰腺炎严重程度进行分类。主要观察指标为农村和种族差异对胰腺炎严重程度的影响。次要观察指标包括临床结局、AP 的病因和再就诊率。
共纳入 468 例患者。农村和城市或毛利和非毛利患者之间在疾病严重程度、住院时间、死亡率或重症监护病房入院率方面无差异。毛利和非毛利患者的病因存在显著差异，毛利人群中胆石性胰腺炎的发生率更高。两组间局部并发症或再就诊次数无差异。
本研究显示，新西兰北地地区农村和城市患者的 AP 严重程度和结局无差异。次要结局在各组间大致相似，与非毛利人群相比，毛利人群胆石性胰腺炎的发生率更高。
