Yazan Abboud, Vraj P Shah, Yi Jiang, Navya Pendyala, Kaveh Hajifathalian
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引用次数: 0
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), (P < 0.05). However, CD patients were at significantly increased odds for deep vein thrombosis (DVT) (OR = 2.240) and hypotensive shock (OR = 1.718) (P < 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.
背景和目的:研究表明,乳糜泻(CD)与急性胰腺炎(AP)发病风险增加有关。批判性分析 CD 与急性胰腺炎预后相关性的文献极少。我们旨在评估近年来 CD 对急性胰腺炎预后和并发症的影响:我们利用 2016 年至 2019 年间的全国住院患者样本(NIS)进行了一项基于人群的分析。在控制人口统计学、并发症和所有患者细化诊断相关组(APR-DRG)严重性风险亚类的同时,进行了多变量逻辑回归,以确定 CD 对 AP 结局的独立影响:从2016年到2019年,共发现2 253 730名AP住院患者,其中4640人(0.2%)患有CD。经多变量分析,在控制人口统计学、合并症和病情严重程度的情况下,CD 患者的死亡率(OR = 0.387)、假性囊肿形成(OR = 0.786)、脓毒症(OR = 0.707)、呼吸衰竭(OR = 0.806)、急性肾损伤(AKI)(OR = 0.804)和心肌梗死(OR = 0.217)的几率显著降低,(P P 结论:我们在全国范围内对 CD 患者的急性肾功能衰竭预后进行的评估研究表明,与非 CD 患者相比,因急性肾功能衰竭入院的 CD 患者的死亡率和其他几项预后往往更好。我们还发现,因 AP 而入院的 CD 患者发生深静脉血栓和低血压休克的风险更高。今后有必要对因 AP 而入院的 CD 患者进行研究,以验证所揭示的发现。