Ye Zhenzhen, Liu Xiaoqing, Ding Sheng, Lu Ling, Zhang Tianchen, Zhou Wenfang, Dong Yonghai
Youth Research and Innovation Team of Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China.
Prevention Rural Environmental Health Technical Guidance Center of Jiangxi Provincial Center for Disease Control, Nanchang, Jiangxi, China.
Front Med (Lausanne). 2024 Oct 22;11:1442276. doi: 10.3389/fmed.2024.1442276. eCollection 2024.
Acute pancreatitis (AP) is a rare but serious complication in patients diagnosed with hemorrhagic fever with renal syndrome (HFRS). When AP complicates HFRS, the clinical outcome significantly worsens and the risk of mortality increases. However, the incidence of AP in HFRS patients and its associated mortality risk remain unclear. To address this knowledge gap, we conducted a meta-analysis to determine the AP incidence rate in HFRS patients and assess the impact of AP on mortality in these patients.
We systematically searched seven databases (PubMed, Web of Science, EMBase, Sinomed, Chinese National Knowledge Infrastructure, WanFang Data, and Chongqing VIP) for relevant studies on HFRS complicated by AP. The studies were selected using predefined inclusion and exclusion criteria based on the Population, Intervention, Comparison, Outcome, and Study design principle. Two independent reviewers screened the studies, and the quality of the included studies was assessed using the Agency for Healthcare Research and Quality and the Newcastle-Ottawa Evaluation Scale (NOS).
In total, 11 studies, encompassing 1,218 HFRS patients, met the inclusion criteria. The overall incidence of HFRS complicated by AP was 8.5% (95% for 5.9-11.1%). The HFRS patients with AP had a significantly higher risk of mortality than those without AP ( = 3.668, 95% for 1.112-12.031). No statistically significant differences were observed in the subgroup and meta-regression analyses.
Although the incidence of AP in HFRS patients is not high, it significantly increases the risk of mortality in these patients. Future large-scale prospective studies are required to further validate these findings.
急性胰腺炎(AP)是肾综合征出血热(HFRS)患者中一种罕见但严重的并发症。当AP并发HFRS时,临床结局显著恶化,死亡风险增加。然而,HFRS患者中AP的发病率及其相关死亡风险仍不清楚。为填补这一知识空白,我们进行了一项荟萃分析,以确定HFRS患者中AP的发病率,并评估AP对这些患者死亡率的影响。
我们系统检索了七个数据库(PubMed、Web of Science、EMBase、中国生物医学文献数据库、中国知网、万方数据和维普资讯),以查找关于HFRS并发AP的相关研究。根据人群、干预措施、对照、结局和研究设计原则,使用预先定义的纳入和排除标准选择研究。两名独立评审员筛选研究,并使用医疗保健研究与质量机构和纽卡斯尔-渥太华评估量表(NOS)评估纳入研究的质量。
共有11项研究,涵盖1218例HFRS患者,符合纳入标准。HFRS并发AP的总体发病率为8.5%(95%置信区间为5.9%-11.1%)。患有AP的HFRS患者的死亡风险显著高于未患AP的患者(比值比=3.668,95%置信区间为1.112-12.031)。在亚组分析和meta回归分析中未观察到统计学显著差异。
尽管HFRS患者中AP的发病率不高,但它显著增加了这些患者的死亡风险。未来需要大规模前瞻性研究来进一步验证这些发现。