药物性急性胰腺炎成人患者 30 天内再住院率及其预测因素：来自美国国家再入院数据库的回顾性研究。

Rates and predictors of 30-day hospital readmissions in adults for drug-induced acute pancreatitis: A retrospective study from the United States National Readmission Database.

机构信息

Department of Internal Medicine, Lincoln Medical Center, Bronx, New York, USA.

Department of Internal Medicine, John H. Stroger Hospital of Cook County, Chicago, Illinois, USA.

出版信息

J Gastroenterol Hepatol. 2023 Aug;38(8):1277-1282. doi: 10.1111/jgh.16177. Epub 2023 Mar 30.

DOI:10.1111/jgh.16177

PMID:36914611

Abstract

BACKGROUND AND AIM

Drug-induced acute pancreatitis (DIAP) linked to several medications is a diagnosis of exclusion and is associated with significant morbidity and mortality, contributing to the US healthcare cost burden. Existing studies on DIAP focus on the drug classes that can cause acute pancreatitis. Hence, our retrospective study aims to determine the rates and predictors for 30-day readmissions (30-DR) in patients with index hospitalization for DIAP.

METHODS

From the Nationwide Readmissions Database, we followed adults admitted for DIAP who were discharged alive for 30 days. During 30-DR, we evaluated the rates, predictors, and outcomes of DIAP.

RESULTS

Of the 4457 DIAP patients surviving at discharge, 12.5% were readmitted at 30 days. During readmissions, the predictors of 30-DR for DIAP were young age, the Charlson-Deyo Comorbidity Index of 2 and 3, protein-energy malnutrition, and dyslipidemia. During 30-DR, DIAP had a higher mortality rate (2.4% vs. 0.7%; P < 0.020), extended hospital stays (5.6 days vs. 4 days, 0.000), and higher hospital charges ($12 983.6 vs. $8 255.6; P 0.000).

CONCLUSIONS

DIAP has high 30-DR rates and poorer outcomes.

摘要

背景与目的

与多种药物相关的药物性急性胰腺炎（DIAP）是一种排除性诊断，与较高的发病率和死亡率相关，并导致美国医疗保健费用负担加重。现有关于 DIAP 的研究主要集中在可能引起胰腺炎的药物类别上。因此，我们的回顾性研究旨在确定 DIAP 指数住院患者 30 天再入院（30-DR）的发生率和预测因素。

方法

我们从全美再入院数据库中随访了存活出院的 DIAP 患者。在 30-DR 期间，我们评估了 DIAP 的发生率、预测因素和结果。

结果

在 4457 例存活出院的 DIAP 患者中，有 12.5%在 30 天内再次入院。在再入院期间，DIAP 30-DR 的预测因素为年龄较小、Charlson-Deyo 合并症指数为 2 或 3、蛋白质能量营养不良和血脂异常。在 30-DR 期间，DIAP 的死亡率更高（2.4%比 0.7%；P<0.020），住院时间延长（5.6 天比 4 天，P<0.000），住院费用更高（12983.6 美元比 8255.6 美元，P<0.000）。