Age- and sex-specific rates of gall bladder disease in children with sickle cell disease.
Age- and sex-specific rates of gall bladder disease in children with sickle cell disease.
复制标题
镰状细胞病儿童胆囊疾病的年龄和性别特定率。
DOI：
10.1002/pbc.29863
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发表时间：
2022
影响因子：
3.2
通讯作者：
Feudtner,Chris
中科院分区：
文献类型：
--
作者：
Agawu,Atu;Shults,Justine;Smith-Whitley,Kim;Feudtner,Chris
镰状细胞病（SCD）患儿由于溶血引起的慢性高胆红素血症而增加了胆结石的风险。虽然胆结石是一种已知的并发症，但性别与胆囊疾病（GBD）之间的相关性的疾病负担和不确定性的估计存在变异性，这是一项使用行政索赔数据（2014年1月1日至2018年12月31日）的SCD儿童回顾性队列研究。使用人群平均多变量面板数据logistic回归模型评价GBD临床遭遇（结局）与两种暴露（年龄和性别）之间的相关性。每年GBD的风险计算预测利润率，调整疾病的严重程度，输血频率，和hydroxyurea exposure.ResultsA共13,745个人（21,487可能）符合纳入标准。人口在性别上均匀分布（49.5%为女性），主要是医疗补助保险（69%）。共有946人（6.9%）患有GBD，432人（3.1%）患有胆结石并发症，487人（3.5%）接受了胆囊切除术。GBD的年风险在1岁至19岁之间非线性地从1%上升到5%，男性和女性之间没有差异。胆囊炎主要发生在GBD患者中（87%），在这一人群中，年龄和性别与胆囊切除术无关。高疾病的严重程度（与低）增加了一倍以上的GBD在所有年龄段的年度风险。ConclusionsGBD与年龄，但不与SCD儿童的性别。年龄和性别与胆囊切除术的风险无关。高疾病严重程度增加了所有年龄段GBD的发生率。
BackgroundChildren with sickle cell disease (SCD) have an increased risk for gallstones due to chronic hyperbilirubinemia from hemolysis. Although gallstones are a known complication, there is variability in estimates of disease burden and uncertainty in the association between sex and gall bladder disease (GBD).MethodsThis was a retrospective cohort study of children with SCD using administrative claims data (January 1, 2014–December 31, 2018). Population‐averaged multivariable panel‐data logistic regression models were used to evaluate the association between GBD clinical encounters (outcome) and two exposures (age and sex). Annual GBD risk was calculated using predictive margins, adjusting for disease severity, transfusion frequency, and hydroxyurea exposure.ResultsA total of 13,745 individuals (of 21,487 possible) met inclusion criteria. The population was evenly split across sex (49.5% female) with predominantly Medicaid insurance (69%). A total of 946 individuals (6.9%) had GBD, 432 (3.1%) had a gallstone complication, and 487 (3.5%) underwent cholecystectomy. The annual risk of GBD rose nonlinearly from 1 to 5% between ages 1 and 19 years with no difference between males and females. Cholecystectomy occurred primarily in individuals with GBD (87%), and neither age nor sex was associated with cholecystectomy in this population. High disease severity (compared with low) more than doubled the annual risk of GBD at all ages.ConclusionsGBD is associated with age but not sex in children with SCD. Neither age nor sex is associated with risk of cholecystectomy. High disease severity increases the rate of GBD at all ages.