特发性急性胰腺炎的临床特点及预后。

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Rambam Maimonides Medical Journal Pub Date : 2021-07-20 DOI:10.5041/RMMJ.10442
Tzvika Porges, Tali Shafat, Iftach Sagy, Dan Schwarzfuchs, Ilan Rahmani Tzvi-Ran, Alan Jotkowitz, Leonid Barski
{"title":"特发性急性胰腺炎的临床特点及预后。","authors":"Tzvika Porges,&nbsp;Tali Shafat,&nbsp;Iftach Sagy,&nbsp;Dan Schwarzfuchs,&nbsp;Ilan Rahmani Tzvi-Ran,&nbsp;Alan Jotkowitz,&nbsp;Leonid Barski","doi":"10.5041/RMMJ.10442","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Acute pancreatitis is a serious diagnosis with an increasing incidence in the Western world. In this study we sought to investigate the incidence of idiopathic AP and to compare clinical and prognostic characteristics of idiopathic cases with cases of AP with known etiology.</p><p><strong>Methods: </strong>In this retrospective study of adult hospitalized patients diagnosed with acute pancreatitis between 2012 and 2015, a comparison was made between admissions of patients with known etiology and those for whom no cause was found. Primary outcome was defined as composite outcome of 30-day mortality and complications.</p><p><strong>Results: </strong>Among 560 admissions of 437 patients with a primary diagnosis of acute pancreatitis, the main factors identified were gallstones (51.2%) and idiopathic pancreatitis (35.9%), with alcohol ranked third at only 4.8%. Mortality rate within 30 days of hospitalization was 2.9% and within one year was 7.1%. Use of lipid-lowering, anti-hypertensive, and anti-diabetic medications was more frequent among patients with \"idiopathic\" disease (70%, 68%, and 33% versus 59%, 56%, and 27%, respectively). Patients admitted with idiopathic AP, in comparison to patients with known AP etiology, had milder disease with shorter hospital stay (3 days versus 4, respectively), and less re-admission in 30 days (7.5% versus 21.2%). Idiopathic AP patients had better prognosis in terms of 30-day death and complication (HR 0.33, 95% CI 0.08-0.40, P<0.001).</p><p><strong>Conclusion: </strong>Idiopathic disease is common among acute pancreatitis patients; the two study groups differed in severity of disease and prognosis. Common use of medications with doubtful value suggests possible under-diagnosis of drug-induced acute idiopathic pancreatitis.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4000,"publicationDate":"2021-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284986/pdf/","citationCount":"4","resultStr":"{\"title\":\"Clinical Characteristics and Prognosis of Idiopathic Acute Pancreatitis.\",\"authors\":\"Tzvika Porges,&nbsp;Tali Shafat,&nbsp;Iftach Sagy,&nbsp;Dan Schwarzfuchs,&nbsp;Ilan Rahmani Tzvi-Ran,&nbsp;Alan Jotkowitz,&nbsp;Leonid Barski\",\"doi\":\"10.5041/RMMJ.10442\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Acute pancreatitis is a serious diagnosis with an increasing incidence in the Western world. In this study we sought to investigate the incidence of idiopathic AP and to compare clinical and prognostic characteristics of idiopathic cases with cases of AP with known etiology.</p><p><strong>Methods: </strong>In this retrospective study of adult hospitalized patients diagnosed with acute pancreatitis between 2012 and 2015, a comparison was made between admissions of patients with known etiology and those for whom no cause was found. Primary outcome was defined as composite outcome of 30-day mortality and complications.</p><p><strong>Results: </strong>Among 560 admissions of 437 patients with a primary diagnosis of acute pancreatitis, the main factors identified were gallstones (51.2%) and idiopathic pancreatitis (35.9%), with alcohol ranked third at only 4.8%. Mortality rate within 30 days of hospitalization was 2.9% and within one year was 7.1%. Use of lipid-lowering, anti-hypertensive, and anti-diabetic medications was more frequent among patients with \\\"idiopathic\\\" disease (70%, 68%, and 33% versus 59%, 56%, and 27%, respectively). Patients admitted with idiopathic AP, in comparison to patients with known AP etiology, had milder disease with shorter hospital stay (3 days versus 4, respectively), and less re-admission in 30 days (7.5% versus 21.2%). Idiopathic AP patients had better prognosis in terms of 30-day death and complication (HR 0.33, 95% CI 0.08-0.40, P<0.001).</p><p><strong>Conclusion: </strong>Idiopathic disease is common among acute pancreatitis patients; the two study groups differed in severity of disease and prognosis. Common use of medications with doubtful value suggests possible under-diagnosis of drug-induced acute idiopathic pancreatitis.</p>\",\"PeriodicalId\":46408,\"journal\":{\"name\":\"Rambam Maimonides Medical Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2021-07-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284986/pdf/\",\"citationCount\":\"4\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Rambam Maimonides Medical Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5041/RMMJ.10442\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rambam Maimonides Medical Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5041/RMMJ.10442","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 4

摘要

目的:急性胰腺炎是一种严重的诊断,在西方世界发病率越来越高。在这项研究中,我们试图调查特发性AP的发病率,并比较特发性病例与已知病因的AP的临床和预后特征。方法:回顾性研究2012 - 2015年诊断为急性胰腺炎的成人住院患者,比较已知病因与未发现病因的住院患者。主要转归定义为30天死亡率和并发症的综合转归。结果:在560,437例初诊急性胰腺炎患者中,确定的主要因素是胆结石(51.2%)和特发性胰腺炎(35.9%),酒精排在第三位,仅为4.8%。住院30天内死亡率为2.9%,1年内死亡率为7.1%。在“特发性”疾病患者中,使用降脂、降压和抗糖尿病药物的频率更高(分别为70%、68%和33%,而不是59%、56%和27%)。与已知AP病因的患者相比,特发性AP患者病情较轻,住院时间较短(分别为3天和4天),30天内再入院率较低(7.5%对21.2%)。特发性AP患者在30天死亡和并发症方面预后较好(HR 0.33, 95% CI 0.08-0.40, p)。两个研究组在疾病严重程度和预后方面存在差异。普遍使用的药物价值可疑提示可能对药物性急性特发性胰腺炎诊断不足。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Clinical Characteristics and Prognosis of Idiopathic Acute Pancreatitis.

Objective: Acute pancreatitis is a serious diagnosis with an increasing incidence in the Western world. In this study we sought to investigate the incidence of idiopathic AP and to compare clinical and prognostic characteristics of idiopathic cases with cases of AP with known etiology.

Methods: In this retrospective study of adult hospitalized patients diagnosed with acute pancreatitis between 2012 and 2015, a comparison was made between admissions of patients with known etiology and those for whom no cause was found. Primary outcome was defined as composite outcome of 30-day mortality and complications.

Results: Among 560 admissions of 437 patients with a primary diagnosis of acute pancreatitis, the main factors identified were gallstones (51.2%) and idiopathic pancreatitis (35.9%), with alcohol ranked third at only 4.8%. Mortality rate within 30 days of hospitalization was 2.9% and within one year was 7.1%. Use of lipid-lowering, anti-hypertensive, and anti-diabetic medications was more frequent among patients with "idiopathic" disease (70%, 68%, and 33% versus 59%, 56%, and 27%, respectively). Patients admitted with idiopathic AP, in comparison to patients with known AP etiology, had milder disease with shorter hospital stay (3 days versus 4, respectively), and less re-admission in 30 days (7.5% versus 21.2%). Idiopathic AP patients had better prognosis in terms of 30-day death and complication (HR 0.33, 95% CI 0.08-0.40, P<0.001).

Conclusion: Idiopathic disease is common among acute pancreatitis patients; the two study groups differed in severity of disease and prognosis. Common use of medications with doubtful value suggests possible under-diagnosis of drug-induced acute idiopathic pancreatitis.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Rambam Maimonides Medical Journal
Rambam Maimonides Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
6.70%
发文量
55
审稿时长
8 weeks
期刊最新文献
IgG4-related Breast Disease: Review of the Literature. Inpatient Rehabilitation is Effective for Severe Daily Activity Deficits Related to Chronic Low Back Pain. Kidnapped But Not Kids: A Case Series of Three Octogenarian Hostages Held in Captivity by Hamas. Myxedema Coma-associated Pancytopenia: A Case Report. The Medical Professional Elimination Program and the Ideology and Motivation of Nazi Physicians.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1