Effects of Gender on Severity, Management and Outcome in Acute Biliary Pancreatitis

被引:19
作者
Shen, Hsiu-Nien [1 ,4 ]
Wang, Wen-Ching [2 ]
Lu, Chin-Li [3 ,4 ]
Li, Chung-Yi [4 ,5 ]
机构
[1] Chi Mei Med Ctr, Dept Intens Care Med, Tainan, Taiwan
[2] Chi Mei Med Ctr, Dept Gen Surg, Tainan, Taiwan
[3] Chi Mei Med Ctr, Dept Med Res, Tainan, Taiwan
[4] Natl Cheng Kung Univ, Coll Med, Dept Publ Hlth, Tainan 70101, Taiwan
[5] China Med Univ, Dept Publ Hlth, Taichung, Taiwan
来源
PLOS ONE | 2013年 / 8卷 / 02期
关键词
GALLSTONE PANCREATITIS; RISK-FACTORS; SEX; MORTALITY; EPIDEMIOLOGY; DIFFERENCE; DISEASE; SURGERY; MEN; CHOLECYSTECTOMY;
D O I
10.1371/journal.pone.0057504
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: We conducted a population-based cross-sectional study to examine gender differences in severity, management, and outcome among patients with acute biliary pancreatitis (ABP) because available data are insufficient and conflicting. Methods: We analyzed 13,110 patients (50.6% male) with first-attack ABP from Taiwan's National Health Insurance Research Database between 2000 and 2009. The primary outcome was hospital mortality. Secondary outcomes included the development of severe ABP and the provision of treatment measures. Gender difference was assessed using multivariable analyses with generalized estimating equations models. Results: The odds of gastrointestinal bleeding (adjusted odds ratio [aOR] 1.44, 95% confidence interval [CI] 1.18-1.76) and local complication (aOR 1.38, 95% CI 1.05-1.82) were 44% and 38% higher in men than in women, respectively. Compared with women, men had 24% higher odds of receiving total parenteral nutrition (aOR 1.24, 95% CI 1.00-1.52), but had 18% and 41% lower odds of receiving cholecystectomy (aOR 0.82, 95% CI 0.72-0.93) and hemodialysis (aOR 0.59, 95% CI 0.42-0.83), respectively. Hospital mortality was higher in men than in women (1.8% vs. 1.1%, p = 0.001). After adjustment for potential confounders, men had 81% higher odds of in-hospital death than women (aOR 1.81, 95% CI 1.15-2.86). Among patients with severe ABP, hospital mortality was 11.0% and 7.5% in men and women (p<0.001), respectively. The adjusted odds of death remained higher in men than in women with severe ABP (aOR 1.72, 95% CI 1.10-2.68). Conclusions: Gender is an important determinant of outcome in patients with ABP and may affect their treatment measures.
引用
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页数:7
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