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乳糜泻与急性胰腺炎入院患者深静脉血栓形成和低血压休克风险增加有关。

Celiac disease is associated with increased risk of deep vein thrombosis and hypotensive shock in patients admitted with acute pancreatitis.

作者信息

Abboud Yazan, Shah Vraj P, Jiang Yi, Pendyala Navya, Hajifathalian Kaveh

机构信息

Department of Internal Medicine Rutgers New Jersey Medical School Newark New Jersey USA.

Karsh Division of Gastroenterology and Hepatology Cedars-Sinai Medical Center Los Angeles California USA.

出版信息

JGH Open. 2024 Aug 24;8(8):e70017. doi: 10.1002/jgh3.70017. eCollection 2024 Aug.

Abstract

BACKGROUND AND AIM

Celiac disease (CD) was shown to be associated with increased risk of developing acute pancreatitis (AP). There is a paucity of literature critically analyzing the association of CD with AP outcomes. We aimed to evaluate the impact of CD on outcomes and complications of AP in recent years.

METHODS

A population-based analysis was performed using the National Inpatient Sample (NIS) between 2016 and 2019. Multivariable logistic regression was conducted to identify the independent impact of CD on AP outcomes while controlling for demographics and comorbidities and all patients refined diagnosis-related groups (APR-DRG) risk of severity subclass.

RESULTS

From 2016 to 2019, a total of 2 253 730 inpatients with AP were identified, of which 4640 (0.2%) had CD. On multivariable analysis, while controlling for demographics, comorbidities, and severity of illness, CD patients had significantly decreased odds for mortality (OR = 0.387), pseudocyst formation (OR = 0.786), sepsis (OR = 0.707), respiratory failure (OR = 0.806), acute kidney injury (AKI) (OR = 0.804), and myocardial infarction (OR = 0.217), ( < 0.05). However, CD patients were at significantly increased odds for deep vein thrombosis (DVT) (OR = 2.240) and hypotensive shock (OR = 1.718) ( < 0.05). Patients with CD had shorter lengths of stay by 0.4 days and lower total charges by $12 690.

CONCLUSIONS

Our nationwide study evaluating AP outcomes in patients with CD suggests that patients with CD admitted for AP tend to have better mortality and several other outcomes compared to non-CD patients. We also show that CD patients admitted for AP have a greater risk for DVT and hypotensive shock. Future studies are warranted to validate the revealed findings in CD patients admitted for AP.

摘要

背景与目的

乳糜泻(CD)被证明与急性胰腺炎(AP)发病风险增加相关。目前缺乏对CD与AP结局之间关联进行批判性分析的文献。我们旨在评估近年来CD对AP结局及并发症的影响。

方法

利用2016年至2019年的全国住院患者样本(NIS)进行基于人群的分析。进行多变量逻辑回归分析,以确定在控制人口统计学和合并症以及所有患者细化诊断相关组(APR-DRG)严重程度亚类风险的情况下,CD对AP结局的独立影响。

结果

2016年至2019年期间,共确定了2253730例AP住院患者,其中4640例(0.2%)患有CD。在多变量分析中,在控制人口统计学、合并症和疾病严重程度的情况下,CD患者的死亡几率(OR = 0.387)、假性囊肿形成几率(OR = 0.786)、脓毒症几率(OR = 0.707)、呼吸衰竭几率(OR = 0.806)、急性肾损伤(AKI)几率(OR = 0.804)和心肌梗死几率(OR = 0.217)显著降低(P < 0.05)。然而,CD患者发生深静脉血栓形成(DVT)的几率(OR = 2.240)和低血压休克几率(OR = 1.718)显著增加(P < 0.05)。CD患者的住院时间缩短了0.4天,总费用降低了12690美元。

结论

我们评估CD患者AP结局的全国性研究表明,与非CD患者相比,因AP住院的CD患者往往有更好的死亡率和其他几种结局。我们还表明,因AP住院的CD患者发生DVT和低血压休克的风险更高。未来有必要进行研究以验证在因AP住院的CD患者中所揭示的发现。

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本文引用的文献

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The Risk of Acute and Chronic Pancreatitis in Celiac Disease.乳糜泻患者发生急性和慢性胰腺炎的风险。
Dig Dis Sci. 2021 Aug;66(8):2691-2699. doi: 10.1007/s10620-020-06546-2. Epub 2020 Aug 18.

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