Worldwide Variations in Demographics, Management, and Outcomes of Acute Pancreatitis.
Worldwide Variations in Demographics, Management, and Outcomes of Acute Pancreatitis.
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DOI：
10.1016/j.cgh.2019.11.017
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发表时间：
2020-06
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影响因子：
--
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很少有研究比较急性胰腺炎的区域差异。我们分析了急性胰腺炎患者的国际注册数据，以评估患者特征、管理和结局的地理差异。我们从急性胰腺炎患者的APPRENTICE登记处收集数据，该登记处使用标准化问卷从欧洲（6家中心）、印度（3家中心）、拉丁美洲（5家中心）和北美（8家中心）的患者中获得信息。我们的最终分析包括2015年8月至2018年1月入组的1612例急性胰腺炎患者（中位年龄49岁; 53%男性，62%白色）。胆源性（45%）和酒精性急性胰腺炎（21%）是最常见的病因。根据修订后的亚特兰大分类，65%的患者出现轻度疾病，23%出现中度疾病，12%出现重度疾病。欧洲患者的平均年龄（58岁）大于所有4个地区的平均年龄（46岁），并且欧洲患者中合并症的比例更高（73% vs 50%）。在拉丁美洲，急性胰腺炎的主要病因是胆源性（78%），而在印度，酒精相关性胰腺炎占急性胰腺炎病例的比例最高（45%）。在北美，93%的患者使用阿片类镇痛剂治疗疼痛，而在其他3个地区，27%的患者使用阿片类镇痛剂治疗疼痛。在拉丁美洲，大多数患者在入院时进行了胆管切除术（60% vs 15%）。与其他3个地区（15%）相比，欧洲重症急性胰腺炎患者在最初住院期间死亡的比例更高（44%）。我们发现世界范围内急性胰腺炎的人口统计学、病因学、管理实践和结局存在显著差异。ClinicalTrials.gov编号：NCT 03075618。
Few studies have compared regional differences in acute pancreatitis. We analyzed data from an international registry of patients with acute pancreatitis to evaluate geographic variations in patient characteristics, management, and outcomes. We collected data from the APPRENTICE registry of patients with acute pancreatitis, which obtains information from patients in Europe (6 centers), India (3 centers), Latin America (5 centers), and North America (8 centers) using standardized questionnaires. Our final analysis included 1612 patients with acute pancreatitis (median age, 49 years; 53% male, 62% white) enrolled from August 2015 through January 2018. Biliary (45%) and alcoholic acute pancreatitis (21%) were the most common etiologies. Based on the revised Atlanta classification, 65% of patients developed mild disease, 23% moderate, and 12% severe. The mean age of patients in Europe (58 years) was older than mean age for all 4 regions (46 years) and a higher proportion of patients in Europe had comorbid conditions (73% vs 50% overall). The predominant etiology of acute pancreatitis in Latin America was biliary (78%), whereas alcohol-associated pancreatitis accounted for the highest proportion of acute pancreatitis cases in India (45%). Pain was managed with opioid analgesics in 93% of patients in North America versus 27% of patients in the other 3 regions. Cholecystectomies were performed at the time of hospital admission for most patients in Latin America (60% vs 15% overall). A higher proportion of European patients with severe acute pancreatitis died during the original hospital stay (44%) compared with the other 3 regions (15%). We found significant variation in demographics, etiologies, management practices, and outcomes of acute pancreatitis worldwide. ClinicalTrials.gov number: NCT03075618.
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影响因子：
3.6
作者：
Lankisch, PG;Assmus, C;Lowenfels, AB
通讯作者：
Lowenfels, AB
影响因子：
12.6
作者：
Wu, Bechien U.;Hwang, James Q.;Conwell, Darwin L.
通讯作者：
Conwell, Darwin L.
DOI：
10.1097/meg.0b013e3283640fc8
发表时间：
2013-09-01
影响因子：
2.1
作者：
Vidarsdottir, Hanna;Moller, Pall H.;Bjornsson, Einar S.
通讯作者：
Bjornsson, Einar S.
影响因子：
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作者：
Besselink, Marc G. H.;Verwer, Thomas J.;Gooszen, Hein G.
通讯作者：
Gooszen, Hein G.
影响因子：
2.9
作者：
Easler JJ;de-Madaria E;Nawaz H;Moya-Hoyo N;Koutroumpakis E;Rey-Riveiro M;Singh VP;Acevedo-Piedra NG;Whitcomb DC;Yadav D;Papachristou GI
通讯作者：
Papachristou GI