Evolving trends in interventions and outcomes for acute biliary pancreatitis during pregnancy: A two-decade analysis

IF 2.8 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology Pub Date : 2025-03-01 DOI:10.1016/j.pan.2025.02.006

Ayushi Jain , Yevgeniya Gokun , Phil A. Hart , Mitchell L. Ramsey , Georgios I. Papachristou , Samuel Han , Peter J. Lee , Hamza Shah , Jordan Burlen , Raj Shah , Erica Park , Somashekar G. Krishna

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引用次数: 0

Abstract

Background/objectives

Cholelithiasis is the most common cause of acute pancreatitis in pregnancy. We analyzed trends in acute biliary pancreatitis (ABP) among pregnant women over the past two decades to evaluate changes in outcomes, including the incidence of severe acute pancreatitis, mortality rates, and hospital length of stay.

Methods

Using the National Inpatient Sample, we identified adult women of childbearing age (age 18–50 years) with hospitalization for ABP from 2002 to 2020. Trends were analyzed using Cochran-Armitage and F-tests. Multivariable binary logistic regression was used to evaluate the outcome of severe acute pancreatitis (SAP).

Results

45,064 pregnant and 212,009 non-pregnant women were hospitalized for ABP (2002–2020), with a significant increase in ABP during pregnancy (14.1 %→17.8 %; p < 0.001). Trend analyses in the pregnant cohort revealed increasing age (mean 27 → 28.1 years; p < 0.001), Class-III obesity (0.7 %→7.8 %; p < 0.001), comorbidities (Elixhauser index ≥3) (2.9 %→11.2 %; p < 0.001), and SAP (2.2 %→5.0 %; p < 0.001). Mortality remained very low (<0.01 %). Performance of ERCP (22.2 %→26.5 %; p < 0.001) and cholecystectomy (41.0 %→54.1 %; p < 0.001) increased while duration of hospitalization decreased (Mean 4.9 → 3.6 days; p < 0.001).

Multivariable analysis revealed that the development of SAP was associated with Black race (OR 1.70, 95 % CI: 1.10–2.63) and comorbidities (OR 5.10, 95 % CI 3.64–7.14).

Conclusions

Pregnant women represent a significant portion of hospitalized ABP cases, paralleling increases in age, comorbidities, and obesity rates. Racial disparities are linked to higher odds of SAP, though comorbidities have a dominant effect. There has been an increase in guideline-recommended procedures (ERCP and cholecystectomy); however, further research is needed to address the implementation gap, considering the increased complexity of pregnant women with ABP.

查看原文本刊更多论文

妊娠期急性胆源性胰腺炎干预措施和结局的发展趋势：二十年分析。

背景/目的：胆石症是妊娠期急性胰腺炎最常见的病因。我们分析了过去二十年来孕妇急性胆源性胰腺炎（ABP）的趋势，以评估结果的变化，包括严重急性胰腺炎的发病率、死亡率和住院时间。方法：使用全国住院患者样本，我们确定了2002年至2020年期间因ABP住院的成年育龄妇女（18-50岁）。采用Cochran-Armitage检验和f检验分析趋势。采用多变量二元logistic回归评价重症急性胰腺炎（SAP）的预后。结果：45,064名孕妇和212,009名非孕妇因ABP住院（2002-2020年），妊娠期ABP显著增加(14.1%→17.8%；结论：孕妇占ABP住院病例的很大一部分，同时年龄、合并症和肥胖率也在增加。种族差异与SAP的高几率有关，尽管共病有主要影响。指南推荐的手术（ERCP和胆囊切除术）有所增加；然而，考虑到ABP孕妇的复杂性增加，需要进一步的研究来解决实施差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.