From the Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH.
the Division of Hospital Medicine, Cincinnati Children's Medical Center, Cincinnati, OH.
J Pediatr Gastroenterol Nutr. 2022 Dec 1;75(6):749-754. doi: 10.1097/MPG.0000000000003610. Epub 2022 Sep 8.
To describe the incidence and presentation of pancreatitis in Children with Medical Complexity (CMC) while evaluating severity of disease and outlining risk factors.
This was a retrospective chart review between January 2010 and December 2019 of patients seen in the complex care clinic at Nationwide Children's Hospital (NCH) and Cincinnati Children's Hospital Medical Center (CCHMC). Data collected included sex, underlying diagnosis, family history of pancreatitis, type of pancreatitis, signs/symptoms, abdominal imaging, severity of attack, and presence of various risk factors associated with pancreatitis. Severity and diagnosis of pancreatitis was determined based on North American Society for Pediatric Gastroenterology, Hepatology and Nutrition criteria.
One hundred and twelve patients from both institutions were included, 62% from NCH, median age 11.5 [interquartile range (IQR): 5-16 years], 50% male. Most patients were less than 18 years of age with a median age of 8 years (IQR: 4-13 years). Underlying diagnoses included seizures (67%), cerebral palsy/spastic quadriplegia (65%), diabetes (3.6%), and mitochondrial disease (3%). Majority of patients were found to have multiple underlying diagnoses (88%). Incidence of pancreatitis for both institutions was 336 of 100,000 patients/year which is significantly higher than the general pediatric population ( P < 0.0001). Majority of first episodes of pancreatitis were mild (82%) with abdominal pain as the predominant symptom (50%). Adult patients were more likely to have pancreatitis related to medication use than pediatric patients (70% vs 38%, respectively P = 0.007).
Individuals in the CMC population at our institutions have a high incidence of pancreatitis with unique risk factors compared to the general pediatric/young adult populations.
描述患有复杂疾病的儿童（CMC）中胰腺炎的发病率和表现，同时评估疾病严重程度并概述危险因素。
这是一项回顾性图表研究，对象为 2010 年 1 月至 2019 年 12 月在全国儿童医院（NCH）和辛辛那提儿童医院医疗中心（CCHMC）复杂护理诊所就诊的患者。收集的数据包括性别、基础诊断、胰腺炎家族史、胰腺炎类型、体征/症状、腹部影像学、疾病严重程度以及与胰腺炎相关的各种危险因素。胰腺炎的严重程度和诊断是基于北美儿童胃肠病学、肝脏病学和营养学会的标准确定的。
共有来自两个机构的 112 名患者入选，其中 62%来自 NCH，中位年龄为 11.5 岁（四分位距：5-16 岁），50%为男性。大多数患者年龄小于 18 岁，中位年龄为 8 岁（四分位距：4-13 岁）。基础诊断包括癫痫（67%）、脑瘫/痉挛性四肢瘫痪（65%）、糖尿病（3.6%）和线粒体疾病（3%）。大多数患者存在多种基础诊断（88%）。两个机构的胰腺炎发病率为 336/100,000 患者/年，明显高于普通儿科人群（P<0.0001）。胰腺炎首次发作的大多数为轻度（82%），以腹痛为主要症状（50%）。成年患者比儿科患者更有可能因药物使用而导致胰腺炎（分别为 70%和 38%，P=0.007）。
与普通儿科/青年人群相比，我们机构的 CMC 人群中胰腺炎的发病率较高，且存在独特的危险因素。
