Pancreatitis in the Complex Care Population: Presentation, Incidence, and Severity.
Pancreatitis in the Complex Care Population: Presentation, Incidence, and Severity.
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DOI：
10.1097/mpg.0000000000003610
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发表时间：
2022-12-01
影响因子：
2.9
通讯作者：
Abu-El-Haija, Maisam
中科院分区：
文献类型：
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作者：
Hawa, Kathryn;Corker, Lisa;Hornung, Lindsey;Noritz, Garey;Gariepy, Cheryl;Shaikhkhalil, Ala;Abu-El-Haija, Maisam
描述医疗复杂性（CMC）儿童胰腺炎的发病率和表现，同时评估疾病的严重程度并概述风险因素。这是对2010年1月至2019年12月期间在全国儿童医院（NCH）和辛辛那提儿童医院医疗中心（CCHMC）的综合护理诊所就诊的患者进行的回顾性病历审查。收集的数据包括性别、基础诊断、胰腺炎家族史、胰腺炎类型、体征/症状、腹部影像学、发作严重程度以及是否存在与胰腺炎相关的各种风险因素。胰腺炎的严重程度和诊断是根据北美儿科胃肠病学、肝病学和营养学会标准确定的。纳入了来自两家机构的112例患者，62%来自NCH，中位年龄11.5岁[四分位距（IQR）：5-16岁]，50%为男性。大多数患者的年龄小于18岁，中位年龄为8岁（IQR：4-13岁）。基础诊断包括癫痫发作（67%）、脑瘫/痉挛性四肢瘫痪（65%）、糖尿病（3.6%）和线粒体疾病（3%）。大多数患者被发现有多个基础诊断（88%）。两个机构的胰腺炎发病率为336/100，000例患者/年，显著高于一般儿科人群（P < 0.0001）。大多数胰腺炎首次发作为轻度（82%），腹痛为主要症状（50%）。与儿科患者相比，成人患者更可能发生与药物使用相关的胰腺炎（分别为70%和38%，P = 0.007）。与一般儿科/年轻成人人群相比，我们机构的CMC人群中的个体胰腺炎发生率较高，具有独特的风险因素。
To describe the incidence and presentation of pancreatitis in Children with Medical Complexity (CMC) while evaluating severity of disease and outlining risk factors. This was a retrospective chart review between January 2010 and December 2019 of patients seen in the complex care clinic at Nationwide Children’s Hospital (NCH) and Cincinnati Children’s Hospital Medical Center (CCHMC). Data collected included sex, underlying diagnosis, family history of pancreatitis, type of pancreatitis, signs/symptoms, abdominal imaging, severity of attack, and presence of various risk factors associated with pancreatitis. Severity and diagnosis of pancreatitis was determined based on North American Society for Pediatric Gastroenterology, Hepatology and Nutrition criteria. One hundred and twelve patients from both institutions were included, 62% from NCH, median age 11.5 [interquartile range (IQR): 5–16 years], 50% male. Most patients were less than 18 years of age with a median age of 8 years (IQR: 4–13 years). Underlying diagnoses included seizures (67%), cerebral palsy/spastic quadriplegia (65%), diabetes (3.6%), and mitochondrial disease (3%). Majority of patients were found to have multiple underlying diagnoses (88%). Incidence of pancreatitis for both institutions was 336 of 100,000 patients/year which is significantly higher than the general pediatric population (P < 0.0001). Majority of first episodes of pancreatitis were mild (82%) with abdominal pain as the predominant symptom (50%). Adult patients were more likely to have pancreatitis related to medication use than pediatric patients (70% vs 38%, respectively P = 0.007). Individuals in the CMC population at our institutions have a high incidence of pancreatitis with unique risk factors compared to the general pediatric/young adult populations.