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心包炎对炎症性肠病患者心血管并发症及医疗资源利用的影响:一项全国住院患者样本研究

Impact of pericarditis on cardiovascular complications and healthcare utilization in patients with inflammatory bowel disease: a National Inpatient Sample study.

作者信息

Garg Ayushi, Menon Rohan, Brar Ajit, Chaudhary Hunza, Sohal Aalam, Kaur Avneet, Brar Vijaywant Singh

机构信息

Trident Medical Center, North Charleston, South Carolina, USA (Ayushi Garg).

Duke University, Durham, North Carolina, USA (Rohan Menon).

出版信息

Ann Gastroenterol. 2025 Jan-Feb;38(1):51-59. doi: 10.20524/aog.2024.0931. Epub 2024 Dec 12.

Abstract

BACKGROUND

Inflammatory bowel disease (IBD), which affects over 2.3 million people in the USA, involves chronic gut inflammation and can lead to cardiovascular complications, including pericarditis. Whether pericarditis in IBD patients is caused by medication, or by the disease itself, remains unclear. Our study aimed to determine the prevalence of pericarditis in IBD and its impact on cardiac complications, outcomes and resource utilization.

METHODS

NIS data were obtained for IBD patients from 2016-2020. Outcomes were assessed using multivariate logistic regression, adjusting for demographics, hospital characteristics, comorbidities, and IBD etiology.

RESULTS

In our study of 1.52 million IBD patients, 0.6% had pericarditis, of whom a majority were women (54.1%) and white (76.3%), over 65 years old (43.1%), enrolled in Medicare (51.7%), and living in urban areas (96.3%). Adjusting for confounding factors, IBD patients with pericarditis had higher odds of cardiac arrest (adjusted odds ratio [aOR] 2.73, 95% confidence interval [CI] 1.90-3.91), cardiogenic shock (aOR 6.42, 95%CI 4.77-8.64), and ventricular arrhythmia (aOR 2.13, 95%CI 1.63-2.78 (P<0.001 for all).

CONCLUSIONS

Our study found that pericarditis, though rare at 0.6%, significantly impacts cardiovascular health and healthcare utilization in IBD patients, with higher prevalence of pericarditis in older individuals, females, and those with comorbidities such as diabetes, hypertension or chronic kidney disease highlighting the need for further research to enhance therapeutic approaches and patient care.

摘要

背景

炎症性肠病(IBD)在美国影响着超过230万人,涉及慢性肠道炎症,并可导致心血管并发症,包括心包炎。IBD患者的心包炎是由药物引起还是由疾病本身引起,仍不清楚。我们的研究旨在确定IBD中心包炎的患病率及其对心脏并发症、结局和资源利用的影响。

方法

获取2016 - 2020年IBD患者的国家住院样本(NIS)数据。使用多因素逻辑回归评估结局,并对人口统计学、医院特征、合并症和IBD病因进行调整。

结果

在我们对152万IBD患者的研究中,0.6%患有心包炎,其中大多数为女性(54.1%)、白人(76.3%)、65岁以上(43.1%)、参加医疗保险(51.7%)且居住在城市地区(96.3%)。在对混杂因素进行调整后,患有心包炎的IBD患者发生心脏骤停的几率更高(调整后的优势比[aOR]为2.73,95%置信区间[CI]为1.90 - 3.91)、心源性休克(aOR为6.42,95%CI为4.77 - 8.64)和室性心律失常(aOR为2.13,95%CI为1.63 - 2.78,所有P<0.001)。

结论

我们的研究发现,心包炎虽然罕见,患病率为0.6%,但对IBD患者的心血管健康和医疗保健利用有显著影响,老年个体、女性以及患有糖尿病、高血压或慢性肾病等合并症的患者心包炎患病率较高,这凸显了进一步研究以改进治疗方法和患者护理的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09cf/11724386/0086350dea55/AnnGastroenterol-38-51-g001.jpg

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