Long-Term Mortality in Acute Pancreatitis-A Population-Based Cohort Study.

IF 5.8 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
United European Gastroenterology Journal Pub Date : 2025-05-01 Epub Date: 2025-02-28 DOI:10.1002/ueg2.12774
Daniel Selin, John Maret-Ouda, Viktor Oskarsson, Mats Lindblad, Urban Arnelo, Bei Yang, Magnus Nilsson, Omid Sadr-Azodi
{"title":"Long-Term Mortality in Acute Pancreatitis-A Population-Based Cohort Study.","authors":"Daniel Selin, John Maret-Ouda, Viktor Oskarsson, Mats Lindblad, Urban Arnelo, Bei Yang, Magnus Nilsson, Omid Sadr-Azodi","doi":"10.1002/ueg2.12774","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis is a potentially life-threatening inflammation of the pancreas, with a rising incidence in most countries. Recent studies have suggested that acute pancreatitis is associated with increased long-term mortality. However, the extent to which this association is influenced by the development of chronic pancreatitis or comorbid conditions, such as malignant disease, remains unclear.</p><p><strong>Objective: </strong>To assess the association between acute pancreatitis and long-term all-cause mortality.</p><p><strong>Methods: </strong>The Swedish Pancreatitis Cohort (SwePan) was used, including all individuals with a first-time episode of acute pancreatitis in Sweden between 1990 and 2019 who survived the index hospital stay and 1:10 matched pancreatitis-free individuals from the general population. Multivariable conditional Cox proportional hazard models were used to compare mortality among individuals with acute pancreatitis compared with the matched pancreatitis-free control group.</p><p><strong>Results: </strong>In total, 89,465 individuals discharged from hospital with acute pancreatitis and 890,837 matched pancreatitis-free individuals were followed up for 10,155,039 person-years (mean 10.0 years). There were 33,764 (37.7%) deaths among individuals with acute pancreatitis and 265,403 (29.8%) deaths among controls. In multivariable adjusted models, mortality was increased in individuals with acute pancreatitis throughout the follow-up period, particularly among those with severe and non-gallstone-related acute pancreatitis as compared to the matched controls. These results remained statistically significant after censoring the follow-up time for recurrent acute pancreatitis or a diagnosis of chronic pancreatitis.</p><p><strong>Conclusions: </strong>Acute pancreatitis was associated with increased long-term mortality, even after adjusting for comorbidities, including cancer, and censoring for recurrent acute pancreatitis or chronic pancreatitis. Future research should assess causes of death and focus on understanding long-term morbidity to facilitate prevention through tailored follow-up strategies.</p>","PeriodicalId":23444,"journal":{"name":"United European Gastroenterology Journal","volume":" ","pages":"640-649"},"PeriodicalIF":5.8000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090827/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"United European Gastroenterology Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ueg2.12774","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/28 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Acute pancreatitis is a potentially life-threatening inflammation of the pancreas, with a rising incidence in most countries. Recent studies have suggested that acute pancreatitis is associated with increased long-term mortality. However, the extent to which this association is influenced by the development of chronic pancreatitis or comorbid conditions, such as malignant disease, remains unclear.

Objective: To assess the association between acute pancreatitis and long-term all-cause mortality.

Methods: The Swedish Pancreatitis Cohort (SwePan) was used, including all individuals with a first-time episode of acute pancreatitis in Sweden between 1990 and 2019 who survived the index hospital stay and 1:10 matched pancreatitis-free individuals from the general population. Multivariable conditional Cox proportional hazard models were used to compare mortality among individuals with acute pancreatitis compared with the matched pancreatitis-free control group.

Results: In total, 89,465 individuals discharged from hospital with acute pancreatitis and 890,837 matched pancreatitis-free individuals were followed up for 10,155,039 person-years (mean 10.0 years). There were 33,764 (37.7%) deaths among individuals with acute pancreatitis and 265,403 (29.8%) deaths among controls. In multivariable adjusted models, mortality was increased in individuals with acute pancreatitis throughout the follow-up period, particularly among those with severe and non-gallstone-related acute pancreatitis as compared to the matched controls. These results remained statistically significant after censoring the follow-up time for recurrent acute pancreatitis or a diagnosis of chronic pancreatitis.

Conclusions: Acute pancreatitis was associated with increased long-term mortality, even after adjusting for comorbidities, including cancer, and censoring for recurrent acute pancreatitis or chronic pancreatitis. Future research should assess causes of death and focus on understanding long-term morbidity to facilitate prevention through tailored follow-up strategies.

急性胰腺炎的长期死亡率——基于人群的队列研究
背景:急性胰腺炎是一种潜在的危及生命的胰腺炎症,在大多数国家发病率都在上升。最近的研究表明,急性胰腺炎与长期死亡率增加有关。然而,这种关联在多大程度上受到慢性胰腺炎或合并症(如恶性疾病)发展的影响仍不清楚。目的:探讨急性胰腺炎与长期全因死亡率的关系。方法:使用瑞典胰腺炎队列(SwePan),包括1990年至2019年期间瑞典所有首次急性胰腺炎发作的患者,这些患者在指数住院期间存活,以及来自一般人群的1:10匹配的无胰腺炎患者。使用多变量条件Cox比例风险模型比较急性胰腺炎患者与匹配的无胰腺炎对照组的死亡率。结果:总共有89,465例急性胰腺炎出院患者和890,837例匹配的无胰腺炎患者随访10,155,039人年(平均10.0年)。急性胰腺炎患者中有33,764例(37.7%)死亡,对照组有265,403例(29.8%)死亡。在多变量调整模型中,与匹配的对照组相比,急性胰腺炎患者的死亡率在整个随访期间都有所增加,特别是那些患有严重和非胆结石相关性急性胰腺炎的患者。在剔除复发性急性胰腺炎或慢性胰腺炎诊断的随访时间后,这些结果仍然具有统计学意义。结论:急性胰腺炎与长期死亡率增加相关,即使在调整了合并症(包括癌症)和复发性急性胰腺炎或慢性胰腺炎后也是如此。未来的研究应评估死亡原因,并侧重于了解长期发病率,以便通过量身定制的后续策略进行预防。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
United European Gastroenterology Journal
United European Gastroenterology Journal GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
10.50
自引率
13.30%
发文量
147
期刊介绍: United European Gastroenterology Journal (UEG Journal) is the official Journal of the United European Gastroenterology (UEG), a professional non-profit organisation combining all the leading European societies concerned with digestive disease. UEG’s member societies represent over 22,000 specialists working across medicine, surgery, paediatrics, GI oncology and endoscopy, which makes UEG a unique platform for collaboration and the exchange of knowledge.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信