Yoshimoto Hidero, Yamakawa Kazuma, Umemura Yutaka, Fujii Kensuke, Nakamura Eriko, Taniguchi Kohei, Tanaka Keitaro, Takasu Akira, Uchiyama Kazuhisa
Department of Surgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan.
Department of Emergency Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan.
J Pers Med. 2021 Dec 10;11(12):1346. doi: 10.3390/jpm11121346.
The seasonal incidence of acute abdomens, such as appendicitis, is reportedly more common in summer but is reported less frequently in Asia. Additionally, seasonal variations in the severity of acute abdomens have been evaluated insufficiently. This study evaluated the seasonal variations in the incidence and severity of acute abdomens in Japan. This retrospective observational study used a multicenter database containing data from 42 acute hospitals in Japan. We included all patients diagnosed with acute appendicitis, diverticulitis, cholecystitis, and cholangitis between January 2011 and December 2019. Baseline patient data included admission date, sequential organ failure assessment score, presence of sepsis, and disseminated intravascular coagulation. We enrolled 24,708 patients with acute abdomen. Seasonal admissions for all four acute abdominal diseases were the highest in summer [acute appendicitis, (OR = 1.35; 95% CI = 1.28-1.43); diverticulitis, (OR = 1.23; 95% CI = 1.16-1.31; cholecystitis (OR = 1.23; 95% CI = 1.11-1.36); and cholangitis (OR = 1.23; 95% CI = 1.12-1.36)]. The proportion of patients with sepsis and disseminated intravascular coagulation as well as the total SOFA score for each disease, did not differ significantly across seasons. Seasonal variations in disease severity were not observed.
据报道,阑尾炎等急腹症的季节性发病率在夏季更为常见,但在亚洲报道较少。此外,对急腹症严重程度的季节性变化评估不足。本研究评估了日本急腹症发病率和严重程度的季节性变化。这项回顾性观察研究使用了一个多中心数据库,其中包含来自日本42家急症医院的数据。我们纳入了2011年1月至2019年12月期间所有诊断为急性阑尾炎、憩室炎、胆囊炎和胆管炎的患者。患者的基线数据包括入院日期、序贯器官衰竭评估评分、是否存在脓毒症以及弥散性血管内凝血。我们纳入了24708例急腹症患者。所有四种急腹症疾病的季节性入院率在夏季最高[急性阑尾炎,(比值比=1.35;95%置信区间=1.28-1.43);憩室炎,(比值比=1.23;95%置信区间=1.16-1.31);胆囊炎(比值比=1.23;95%置信区间=1.11-1.36);胆管炎(比值比=1.23;95%置信区间=1.12-1.36)]。脓毒症和弥散性血管内凝血患者的比例以及每种疾病的总序贯器官衰竭评估评分在各季节之间没有显著差异。未观察到疾病严重程度的季节性变化。