Danish Patients With Chronic Pancreatitis Have a Four-Fold Higher Mortality Rate Than the Danish Population
Danish Patients With Chronic Pancreatitis Have a Four-Fold Higher Mortality Rate Than the Danish Population
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DOI：
10.1016/j.cgh.2009.12.016
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发表时间：
2010-04-01
影响因子：
12.6
通讯作者：
Matzen, Peter
中科院分区：
文献类型：
--
作者：
Nojgaard, Camilla;Bendtsen, Flemming;Matzen, Peter
背景与目的：我们调查了慢性胰腺炎 (CP) 患者的死亡率，并与丹麦人群进行比较，并试图确定 CP 的临床表现是否可用于预后。我们还调查了与这些患者的死亡率和死因相关的临床因素。方法：哥本哈根胰腺炎研究是一项前瞻性研究，研究对象为 1977 年至 1982 年哥本哈根 5 家主要医院收治的诊断为急性胰腺炎或 CP 的患者。 2008 年，丹麦登记处收集了这些患者的随访数据；该亚组由 290 名疑似 CP（n = 41）或明确 CP（n = 249）的患者组成。结果：明确 Cl 患者的死亡率是丹麦人群的 4 倍，并且显着高于可能 Cl 患者的死亡率（P = 0.003；95% 置信区间 [CI]，1.21-2.57）；疑似 CP 患者的死亡率比普通人群高 2 至 3 倍。在确诊 CP 的患者中，与死亡率显着相关的因素包括未就业（P = .015；95% CI，0.53-0.93）和体重不足（P = .020；95% CI，0.52-0.95）。性别、饮酒、吸烟、单身与共同生活、外分泌功能不全、糖尿病、胰腺钙化、CP遗传、无痛CP、CP急性恶化或CP手术对生存没有影响。最常见的死因是消化系统疾病（19.5%）、恶性肿瘤（19.5%）和心血管疾病（11.3%）。结论：丹麦确诊 CP 患者的死亡率是背景人群的 4 倍，并且比疑似 CP 患者的死亡率更高。失业或体重不足对生存有重大影响。
BACKGROUND & AIMS: We investigated mortality of patients with chronic pancreatitis (CP), compared with the Danish population and sought to determine whether clinical presentations of CP can be used in prognosis. We also investigated clinical factors associated with mortality and causes of death among these patients. METHODS: The Copenhagen Pancrearitis Study is a prospective study of patients admitted from 1977 to 1982 to the 5 main hospitals in Copenhagen with a diagnosis of acute pancreatitis or CP. In 2008, follow-up data were collected from these patients from the Danish Registries; this subcohort comprised 290 patients with probable (n = 41) or definite CP (n = 249). RESULTS: The mortality of patients with definite Cl was 4-fold that of the Danish population and significantly higher than that of patients with probable Cl (P = .003; 95% confidence interval [CI], 1.21-2.57); patients with probable CP had a 2- to 3-fold higher mortality rate than the population. In patients with definite CP, factors significantly associated with mortality included non-employment (P = .015; 95% CI, 0.53-0.93), and being underweight (P = .020; 95% CI, 0.52-0.95). Sex, alcohol use, smoking, single versus co-living, exocrine insufficiency, diabetes, pancreatic calcification, CP inheritance, painless CP, acute exacerbation of CP, or surgery for CP had no impact on survival. The most frequent causes of death were digestive diseases (19.5%), malignancies (19.5%), and cardiovascular diseases (11.3%). CONCLUSIONS: Danish patients with definite CP had a 4-fold higher mortality rate compared with the background population and a higher mortality rate than patients with probable CP. Being non-employed or underweight had significant impact on survival.