Patients With Sentinel Acute Pancreatitis of Alcoholic Etiology Are at Risk for Organ Failure and Pancreatic Necrosis: A Dual-Center Experience.
Patients With Sentinel Acute Pancreatitis of Alcoholic Etiology Are at Risk for Organ Failure and Pancreatic Necrosis: A Dual-Center Experience.
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DOI：
10.1097/mpa.0000000000000643
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发表时间：
2016-08
期刊：
影响因子：
2.9
通讯作者：
Papachristou GI
中科院分区：
文献类型：
--
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
评估酒精病因、烟草使用与重症急性胰腺炎（SAP）之间的关系。在美国（U.S.）的急性胰腺炎患者队列中，记录了入院时的吸烟和酒精暴露。对首次急性胰腺炎（AP）“前哨”发作的患者进行分析。在来自西班牙的独立患者队列中验证了酒精、吸烟和SAP之间的关联。美国队列（n=222）：35%发生器官衰竭（OF），35%发生胰腺坏死（PNec），7%死亡。与其他病因相比，酒精性患者的OF（54% vs. 33%，p=0.03）、PNec（62% vs. 31%，p=0.006）、重症监护（ICU）入院率（58% vs. 36%，p=0.03）和住院时间（LOS）（20 vs. 8天，p= 0.007）更高。西班牙队列（n=366）：酒精性和非酒精性病因之间的结局也存在类似差异：OF（24% vs. 8%，p=0.001），PNec（38% vs. 14%，p<0.001），ICU入院（20% vs. 3%，p<0.001）和LOS（17 vs. 11天，p=0.04）。多变量分析证实酒精病因与两个队列中的OF和PNec独立相关。酒精性病因与前哨AP患者的OF和PNec独立相关，在评估AP严重疾病的风险时非常重要。
Assess the relationship between alcoholic etiology, tobacco use and severe acute pancreatitis (SAP). Smoking and alcohol exposure were recorded upon admission in a cohort of acute pancreatitis patients within the United States (U.S.). Patients with first, “sentinel” attack of acute pancreatitis (AP) were identified for analysis. Associations between alcohol, smoking and SAP were validated in an independent cohort of patients from Spain. U.S. cohort (n=222): Thirty-five% developed organ failure (OF), 35% Pancreatic Necrosis (PNec), and 7% died. OF (54% vs. 33%, p=0.03), PNec (62% vs. 31%, p=0.006), intensive care (ICU) admission (58% vs. 36%, p=0.03) and length of stay (LOS) (20 vs. 8 days, p= 0.007) were greater in alcoholic when compared to other etiologies. Spanish cohort (n=366): Similar differences in outcomes were also found with between alcoholic and non-alcoholic etiologies: OF (24% vs. 8%, p=0.001), PNec (38% vs. 14%, p<0.001), ICU admission (20% vs. 3%, p<0.001), and LOS (17 vs. 11 days, p=0.04). Multivariable analysis confirmed alcoholic etiology to be independently associated with OF and PNec in both cohorts. Alcoholic etiology is independently associated with OF and PNec in patients with sentinel AP and is important when evaluating risk for severe disease in AP.