Gagyi Endre-Botond, Teutsch Brigitta, Veres Dániel Sándor, Pálinkás Dániel, Vörhendi Nóra, Ocskay Klementina, Márta Katalin, Hegyi Péter Jenő, Hegyi Péter, Erőss Bálint
Center for Translational Medicine, Semmelweis University, Budapest, Hungary.
Selye János Doctoral College for Advanced Studies, Semmelweis University, Budapest, Hungary.
Therap Adv Gastroenterol. 2024 Jun 14;17:17562848241255303. doi: 10.1177/17562848241255303. eCollection 2024.
Acute pancreatitis (AP) has a high incidence, and patients can develop recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) after AP.
We aimed to estimate the pooled incidence rates (IRs), cumulative incidences, and proportions of RAP and CP after AP.
A systematic review and meta-analysis of studies reporting the proportion of RAP and CP after AP.
The systematic search was conducted in three (PubMed, EMBASE, and CENTRAL) databases on 19 December 2023. Articles reporting the proportion of RAP or CP in patients after the first and multiple episodes of AP were eligible. The random effects model was used to calculate the pooled IR with 95% confidence intervals (CIs). The value assessed heterogeneity. The risk of bias assessment was conducted with the Joanna Briggs Institute Critical Appraisal Tool.
We included 119 articles in the quantitative synthesis and 29 in the IRs calculations. Our results showed that the IR of RAP in adult patients after AP was 5.26 per 100 person-years (CI: 3.99-6.94; = 93%), while in children, it was 4.64 per 100 person-years (CI: 2.73-7.87; = 88%). We also found that the IR of CP after AP was 1.4 per 100 person-years (CI: 0.9-2; = 75%), while after RAP, it increased to 4.3 per 100 person-years (CI: 3.1-6.0; = 76%). The risk of bias was moderate in the majority of the included studies.
Our results showed that RAP affects many patients with AP. Compared to patients with the first AP episode, RAP leads to a threefold higher IR for developing CP.
Our protocol was registered on PROSPERO (CRD42021283252).
急性胰腺炎（AP）发病率较高，患者在AP后可能发展为复发性急性胰腺炎（RAP）和慢性胰腺炎（CP）。
我们旨在估计AP后RAP和CP的合并发病率、累积发病率及比例。
对报告AP后RAP和CP比例的研究进行系统评价和荟萃分析。
于2023年12月19日在三个数据库（PubMed、EMBASE和CENTRAL）中进行系统检索。纳入首次及多次AP发作后患者中RAP或CP比例的报告文章。采用随机效应模型计算合并发病率及95%置信区间（CI）。I²值评估异质性。使用乔安娜·布里格斯研究所批判性评价工具进行偏倚风险评估。
我们纳入了119篇进行定量合成的文章和29篇进行发病率计算的文章。结果显示，成人患者AP后RAP的发病率为每100人年5.26例（CI：3.99 - 6.94；I² = 93%），而儿童为每100人年4.64例（CI：2.73 - 7.87；I² = 88%）。我们还发现，AP后CP的发病率为每100人年1.4例（CI：0.9 - 2；I² = 75%），而RAP后则增至每100人年4.3例（CI：3.1 - 6.0；I² = 76%）。纳入的大多数研究偏倚风险为中度。
我们的结果表明，RAP影响许多AP患者。与首次发作AP的患者相比，RAP导致发生CP的发病率高出三倍。
我们的方案在PROSPERO（CRD42021283252）上注册。
