Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital of Nanchang University, No. 17 Yong Waizheng Street, Nanchang, Jiangxi Province 330006, China.
Center of Severe Acute Pancreatitis (CSAP), Department of Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, No. 305 Zhongshan East Road, Nanjing Jiangsu 210002, China.
Eur J Intern Med. 2024 Jul;125:98-103. doi: 10.1016/j.ejim.2024.03.022. Epub 2024 Mar 27.
There are scarce prospective data on recurrent hypertriglyceridemia-associated acute pancreatitis (HTG-AP). This study aimed to investigate the incidence, potential prognostic factors, and clinical relevance of recurrent HTG-AP.
This study is a multicenter, prospective cohort study. Adult patients with the first HTG-AP attack enrolled in the PERFORM registry between November 2020 and December 2021 were involved. All the study patients were followed up for more than two years with a two-round schedule. The Cox proportional-hazards model was applied to analyze the potential factors. Quality of life was evaluated using the EuroQol five-dimensional five-level health scale (EQ-5D-5L).
A total of 184 patients from 25 sites were included in the study, and 161 patients completed the two-round follow-up. Among them, the mean follow-up time for the study patients was 31±4 months, and the incidence rate of recurrent HTG-AP attack was 23 % (37/161). All patients with recurrent episodes required readmission to the hospital. The EQ visual analog scale (VAS) score was significantly lower in patients with recurrent episodes compared to those without (76±10 vs. 82±12; P = 0.02) at the latest follow-up. Age <40 years old (hazard ratio [HR], 3.6; 95 % confidence interval [CI], 1.5-8.7; P = 0.004) and a history of diabetes (HR, 2.6; 95 %CI, 1.3-5.1; P = 0.005) were identified as potential predictor factors for recurrence.
Recurrence of HTG-AP is common, especially for younger patients with diabetes. Recurrence necessitated additional hospital readmissions and was associated with compromised quality of life.
复发性高甘油三酯血症相关急性胰腺炎(HTG-AP)的前瞻性数据稀缺。本研究旨在探讨复发性 HTG-AP 的发生率、潜在预后因素和临床相关性。
这是一项多中心前瞻性队列研究。纳入 2020 年 11 月至 2021 年 12 月期间参与 PERFORM 登记研究的首次 HTG-AP 发作的成年患者。所有研究患者均进行了超过两年的随访,随访间隔为两轮。采用 Cox 比例风险模型分析潜在因素。使用欧洲五维健康量表(EQ-5D-5L)评估生活质量。
本研究共纳入 25 个研究中心的 184 例患者,其中 161 例完成了两轮随访。研究患者的平均随访时间为 31±4 个月,复发性 HTG-AP 发作的发生率为 23%(37/161)。所有复发性发作的患者均需再次住院治疗。与无复发患者相比,复发性发作患者的 EQ 视觉模拟量表(VAS)评分在末次随访时显著降低(76±10 与 82±12;P=0.02)。年龄<40 岁(风险比 [HR],3.6;95%置信区间 [CI],1.5-8.7;P=0.004)和糖尿病史(HR,2.6;95%CI,1.3-5.1;P=0.005)是复发的潜在预测因素。
HTG-AP 的复发较为常见,尤其是年轻合并糖尿病的患者。复发需要再次住院治疗,且与生活质量受损有关。