M. E. Cook, Niels Henrik Bruun, Line Davidsen, P. Vestergaard, A. M. Drewes, S. S. Olesen
{"title":"曾患急性胰腺炎和未患急性胰腺炎的慢性胰腺炎患者的代谢后遗症和全因死亡率:基于全国人口的队列研究》。","authors":"M. E. Cook, Niels Henrik Bruun, Line Davidsen, P. Vestergaard, A. M. Drewes, S. S. Olesen","doi":"10.14309/ajg.0000000000002799","DOIUrl":null,"url":null,"abstract":"OBJECTIVES\nTo investigate the risk of metabolic sequelae and all-cause mortality in a population-based cohort of chronic pancreatitis (CP) patients with and without prior acute pancreatitis (AP).\n\n\nMETHODS\nWe used nationwide health registries to identify all Danish residents (>18 years) with incident CP from 2000-2018. Information on AP/CP diagnoses, metabolic sequelae (post-pancreatitis diabetes mellitus (PPDM), exocrine pancreatic dysfunction (EPD), and osteoporosis), and all-cause mortality were obtained from Danish national health registries. CP cases were stratified based on the presence of AP prior to CP diagnosis. The risk of metabolic sequelae and all-cause mortality was expressed as hazard ratios (HRs) with 95% confidence intervals (CIs), calculated using multivariate Cox proportional hazards models.\n\n\nRESULTS\nA total of 9655 CP patients were included. Among CP patients, 3913 (40.5%) had a prior AP diagnosis. Compared to patients without a history of AP, patients with prior AP had a decreased risk of death (HR 0.79 (95% CI, 0.74-0.84)), which was largely confined to the initial period after CP diagnosis. Patients with prior AP had an increased risk of PPDM (HR 1.53 (95% CI, 1.38-1.69)), which persisted for up to a decade after CP diagnosis. No overall differences in risk were observed for EPD (HR 0.97 (95% CI, 0.87-1.07)) and osteoporosis (HR 0.87 (95% CI, 0.74-1.02)).\n\n\nCONCLUSIONS\nThis nationwide study revealed that the majority of CP patients have no prior episode(s) of AP, indicating that an attack of AP sensitizing the pancreas is not essential for CP development. CP patients with and without prior AP have different risk profiles of PPDM and all-cause mortality.","PeriodicalId":507623,"journal":{"name":"The American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Metabolic Sequelae and All-Cause Mortality in Chronic Pancreatitis With and Without Prior Acute Pancreatitis: A Nationwide Population-Based Cohort Study.\",\"authors\":\"M. E. Cook, Niels Henrik Bruun, Line Davidsen, P. Vestergaard, A. M. Drewes, S. S. Olesen\",\"doi\":\"10.14309/ajg.0000000000002799\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVES\\nTo investigate the risk of metabolic sequelae and all-cause mortality in a population-based cohort of chronic pancreatitis (CP) patients with and without prior acute pancreatitis (AP).\\n\\n\\nMETHODS\\nWe used nationwide health registries to identify all Danish residents (>18 years) with incident CP from 2000-2018. Information on AP/CP diagnoses, metabolic sequelae (post-pancreatitis diabetes mellitus (PPDM), exocrine pancreatic dysfunction (EPD), and osteoporosis), and all-cause mortality were obtained from Danish national health registries. CP cases were stratified based on the presence of AP prior to CP diagnosis. The risk of metabolic sequelae and all-cause mortality was expressed as hazard ratios (HRs) with 95% confidence intervals (CIs), calculated using multivariate Cox proportional hazards models.\\n\\n\\nRESULTS\\nA total of 9655 CP patients were included. Among CP patients, 3913 (40.5%) had a prior AP diagnosis. Compared to patients without a history of AP, patients with prior AP had a decreased risk of death (HR 0.79 (95% CI, 0.74-0.84)), which was largely confined to the initial period after CP diagnosis. Patients with prior AP had an increased risk of PPDM (HR 1.53 (95% CI, 1.38-1.69)), which persisted for up to a decade after CP diagnosis. No overall differences in risk were observed for EPD (HR 0.97 (95% CI, 0.87-1.07)) and osteoporosis (HR 0.87 (95% CI, 0.74-1.02)).\\n\\n\\nCONCLUSIONS\\nThis nationwide study revealed that the majority of CP patients have no prior episode(s) of AP, indicating that an attack of AP sensitizing the pancreas is not essential for CP development. CP patients with and without prior AP have different risk profiles of PPDM and all-cause mortality.\",\"PeriodicalId\":507623,\"journal\":{\"name\":\"The American Journal of Gastroenterology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The American Journal of Gastroenterology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14309/ajg.0000000000002799\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The American Journal of Gastroenterology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14309/ajg.0000000000002799","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Metabolic Sequelae and All-Cause Mortality in Chronic Pancreatitis With and Without Prior Acute Pancreatitis: A Nationwide Population-Based Cohort Study.
OBJECTIVES
To investigate the risk of metabolic sequelae and all-cause mortality in a population-based cohort of chronic pancreatitis (CP) patients with and without prior acute pancreatitis (AP).
METHODS
We used nationwide health registries to identify all Danish residents (>18 years) with incident CP from 2000-2018. Information on AP/CP diagnoses, metabolic sequelae (post-pancreatitis diabetes mellitus (PPDM), exocrine pancreatic dysfunction (EPD), and osteoporosis), and all-cause mortality were obtained from Danish national health registries. CP cases were stratified based on the presence of AP prior to CP diagnosis. The risk of metabolic sequelae and all-cause mortality was expressed as hazard ratios (HRs) with 95% confidence intervals (CIs), calculated using multivariate Cox proportional hazards models.
RESULTS
A total of 9655 CP patients were included. Among CP patients, 3913 (40.5%) had a prior AP diagnosis. Compared to patients without a history of AP, patients with prior AP had a decreased risk of death (HR 0.79 (95% CI, 0.74-0.84)), which was largely confined to the initial period after CP diagnosis. Patients with prior AP had an increased risk of PPDM (HR 1.53 (95% CI, 1.38-1.69)), which persisted for up to a decade after CP diagnosis. No overall differences in risk were observed for EPD (HR 0.97 (95% CI, 0.87-1.07)) and osteoporosis (HR 0.87 (95% CI, 0.74-1.02)).
CONCLUSIONS
This nationwide study revealed that the majority of CP patients have no prior episode(s) of AP, indicating that an attack of AP sensitizing the pancreas is not essential for CP development. CP patients with and without prior AP have different risk profiles of PPDM and all-cause mortality.