Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Pancreatology. 2023 Nov;23(7):761-766. doi: 10.1016/j.pan.2023.08.001. Epub 2023 Aug 5.
BACKGROUND/OBJECTIVE: Alcohol consumption is increasing in women, who more frequently report abdominal symptoms compared to men. We aimed to examine differences in presentation of acute pancreatitis [AP] in male and female patients hospitalized with alcohol-associated AP.
We analyzed 138 patients enrolled in an ongoing case-crossover study of alcohol-associated AP conducted across 5 medical centers in the U.S. Patients meeting the Revised Atlanta Classification of AP and who scored 3 or higher on the AUDIT-C instrument were invited to participate in the study and were interviewed while hospitalized with AP. Sex differences in the timing and type of pancreas-associated pain, alcohol consumption, clinical presentation, and quality of life were examined by Chi-squared tests, Wilcoxon rank sum tests and t-tests.
Female patients reported significantly longer interval from onset of pain to deciding to seek medical attention (median 40 h, interquartile range [IQR] 14, 74) as compared to males (14 h, IQR 4, 50; p = 0.005). While male patients were more likely to have been admitted to the intensive care unit [ICU] (21%) as compared to female patients (7%; p = 0.04), the incidence of SIRS or severe AP did not differ by sex. Quality of life measures as reported through the PROMIS-29 instrument were equally suboptimal in both sexes. Anxiety disorders were diagnosed more frequently among females (61%) than in males (41%, p = 0.009).
In a large case series of alcohol-associated AP, we found that female patients delayed seeking medical care compared to males. However, there were no differences in the type, location and intensity of abdominal pain.
背景/目的：女性的饮酒量正在增加，她们比男性更频繁地报告腹部症状。我们旨在研究因酒精相关性急性胰腺炎（AP）住院的男性和女性患者在 AP 表现方面的差异。
我们分析了在美国 5 家医疗中心进行的一项正在进行的酒精相关性 AP 病例交叉研究中纳入的 138 名患者。符合修订亚特兰大分类标准且 AUDIT-C 量表评分≥3 分的患者被邀请参与研究，并在因 AP 住院期间接受访谈。通过卡方检验、Wilcoxon 秩和检验和 t 检验，比较了胰腺相关疼痛的时间和类型、饮酒、临床表现和生活质量方面的性别差异。
与男性（14 小时，四分位距[IQR]4,50）相比，女性患者报告的疼痛开始到决定就医的间隔时间明显更长（中位数 40 小时，IQR14,74；p=0.005）。虽然男性患者更有可能被收入重症监护病房（ICU）（21%），而女性患者（7%；p=0.04），但 SIRS 或严重 AP 的发生率不因性别而异。通过 PROMIS-29 仪器报告的生活质量测量同样在两性中都不理想。女性中诊断出焦虑障碍的比例（61%）高于男性（41%，p=0.009）。
在一项大型酒精相关性 AP 病例系列研究中，我们发现女性患者比男性患者更晚寻求医疗救助。然而，腹痛的类型、部位和强度没有差异。
