Huang Yining, Qiu Minhao, Pan Shuang, Zhou Yan, Huang Xiaoyi, Jin Yinglu, Zippi Maddalena, Fiorino Sirio, Zimmer Vincent, Hong Wandong
Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.
Ann Med. 2025 Dec;57(1):2442073. doi: 10.1080/07853890.2024.2442073. Epub 2024 Dec 19.
To evaluate temporal trends in gender, etiology, severity, outcomes, cost and median length of stay (MLS) in patients with acute pancreatitis (AP) in a third-tier Chinese city.
Patients with AP admitted to a university hospital between January 2013 and December 2021. Relationships between etiology, prevalence of severe acute pancreatitis (SAP) and survey years were investigated by joinpoint regression analysis.
A total of 5459 (male 62.3%) patients with AP were included. Between January 2013 and December 2021, we observed: (a) the prevalence of biliary diseases-related AP was stable, while the prevalence of hypertriglyceridemia (HTG)-associated AP (P = 0.04) and alcohol-associated AP (P < 0.0001) both increased; (b) there was an increase in crude prevalence of SAP from 4.97% to 12.2% between 2013 and 2021 (P < 0.0001); (c) compared to female populations, male gender had a higher prevalence of AP; (d) there was a decrease in MLS from 11 days to 8 days (P < 0.0001) and in median cost of hospitalization (MCH) for all patients (from 20,166 to 12,845 YUAN) (P < 0.0001); (e) the overall in-hospital mortality rate was 1.28% (70/5459) for patients with AP. There was no statistically significant in the time trend of mortality during the study period (P = 0.5873). At multivariate analysis, survey year was associated with prevalence of SAP after adjustment by age and biliary diseases (OR: 1.07; 95% CI: 1.03-1.12). Based on the stratification by severity of disease, the decrease of MLS and MCH was more significant in non-SAP vs. SAP patients.
Over the observational period, the proportion of male patients with AP, prevalence of age-adjusted rate of HTG and alcohol-associated AP and SAP increased, while MLS and MCH for all patients decreased, and the time trend of mortality of AP was stable.
评估中国三线城市急性胰腺炎(AP)患者在性别、病因、严重程度、预后、费用及中位住院时间(MLS)方面的时间趋势。
纳入2013年1月至2021年12月在某大学医院住院的AP患者。采用Joinpoint回归分析研究病因、重症急性胰腺炎(SAP)患病率与调查年份之间的关系。
共纳入5459例AP患者(男性占62.3%)。2013年1月至2021年12月期间,我们观察到:(a)胆源性AP患病率稳定,而高甘油三酯血症(HTG)相关性AP(P = 0.04)和酒精性AP(P < 0.0001)患病率均上升;(b)2013年至2021年期间,SAP的粗患病率从4.97%升至12.2%(P < 0.0001);(c)与女性人群相比,男性AP患病率更高;(d)所有患者的MLS从11天降至8天(P < 0.0001),住院费用中位数(MCH)也降低(从20166元降至12845元)(P < 0.0001);(e)AP患者的总体院内死亡率为1.28%(70/5459)。研究期间死亡率的时间趋势无统计学意义(P = 0.5873)。多因素分析显示,经年龄和胆源性疾病校正后,调查年份与SAP患病率相关(OR:1.07;95%CI:1.03 - 1.12)。按疾病严重程度分层后,非SAP患者的MLS和MCH下降幅度比SAP患者更显著。
在观察期内,男性AP患者比例、年龄调整后的HTG和酒精性AP及SAP患病率上升,而所有患者的MLS和MCH下降,AP死亡率的时间趋势稳定。