Amakye Dominic, Bundschuh Mark, Walter Vonn, Headlee Brandon, Razjouyan Hadie, Coates Matthew
Department of Graduate Medical Education, Piedmont Athens Regional Hospital, GA, USA (Dominic Amakye).
Division of Gastroenterology and Hepatology, Department of Medicine, Penn State College of Medicine, Hershey, PA, USA (Mark Bundschuh, Brandon Headlee, Hadie Razjouyan, Matthew Coates).
Ann Gastroenterol. 2024 Sep-Oct;37(5):618-622. doi: 10.20524/aog.2024.0908. Epub 2024 Aug 19.
Silent chronic pancreatitis (SCP) is a poorly understood subtype of chronic pancreatitis (CP) in which individuals describe little to no abdominal pain. The risk factors for SCP are unclear, and it is unknown whether there are differences in the clinical outcomes of SCP and painful CP. We set out to investigate the clinical features of SCP and the risk factors associated with this condition.
This was a retrospective cohort study using data from the Penn State Milton S. Hershey Medical Center from 2019-2022. Two patient groups, the SCP cohort (23 patients) and the painful CP cohort (94 patients), were identified from consecutive clinics. Descriptive statistics and bivariate and logistic regression analyses (including variables with a P-value <0.1 on bivariate analysis) were performed to characterize the study cohort and to evaluate for independent associations with SCP.
SCP was independently associated with older age (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.01-1.11; P=0.03) and male sex (OR 5.38, 95%CI 1.38-20.96; P=0.02), and inversely associated with current opioid use (OR 0.18, 95%CI 0.03-0.96; P=0.04). There was no association between SCP and current pain medication or diabetes mellitus.
Our study adds to the growing body of literature describing SCP as a condition associated with older age and male sex, and inversely associated with opioid use. We found no greater association of diabetes with SCP. Future larger longitudinal studies are needed to gain a better understanding of SCP.
无症状慢性胰腺炎（SCP）是慢性胰腺炎（CP）的一种鲜为人知的亚型，患者几乎没有或完全没有腹痛症状。SCP的危险因素尚不清楚，SCP与疼痛性CP的临床结局是否存在差异也不明确。我们旨在研究SCP的临床特征以及与该疾病相关的危险因素。
这是一项回顾性队列研究，使用了宾夕法尼亚州立大学米尔顿·S·赫尔希医疗中心2019年至2022年的数据。从连续就诊的患者中确定了两个患者组，即SCP队列（23例患者）和疼痛性CP队列（94例患者）。进行了描述性统计、双变量和逻辑回归分析（包括双变量分析中P值<0.1的变量），以描述研究队列并评估与SCP的独立关联。
SCP与年龄较大（比值比[OR]1.06，95%置信区间[CI]1.01-1.11；P=0.03）和男性（OR 5.38，95%CI 1.38-20.96；P=0.02）独立相关，与当前使用阿片类药物呈负相关（OR 0.18，95%CI 0.03-0.96；P=0.04）。SCP与当前使用的止痛药物或糖尿病之间没有关联。
我们的研究进一步丰富了关于SCP的文献，表明SCP与年龄较大和男性相关，与阿片类药物使用呈负相关。我们发现糖尿病与SCP之间没有更强的关联。未来需要进行更大规模的纵向研究，以更好地了解SCP。
