Incidence Rate Of Pancreatitis Research Articles

Nursing Risk Management in the Prevention of Post-ERCP Pancreatitis

Objective: To study the role of nursing risk management in the prevention of post-ERCP pancreatitis. Methods: 80 patients who underwent ERCP in our hospital from December 2023 to April 2024 were selected and randomly divided into an observation group and a control group using the random number table method, with 40 cases in each group. The observation group was given nursing risk management interventions and patients in the control group were given routine nursing interventions, and the patients in the two groups were compared in the incidence rate of pancreatitis and the satisfaction of nursing care. Results: The incidence of postoperative pancreatitis in the observation group was significantly lower than in the control group (P < 0.05). The patient satisfaction of the observation group was significantly higher than that of the control group (P < 0.05). Conclusion: Nursing risk management after ERCP can reduce the incidence of postoperative pancreatitis and improve patient satisfaction.

Social disparity is associated with an increased risk of acute and chronic pancreatitis.

To study social disparity in acute pancreatitis (AP) and chronic pancreatitis (CP).We also aimed at exploring whether an interaction exists between alcohol intake and socioeconomic factors. Prospective cohort study based on data from 271696 men and women participating in the Danish National Health Surveys 2010, and 2013. Information on alcohol and smoking parameters, body mass index (BMI), diet, and education, were self-reported and information on family income was obtained from administrative registers. Outcome variables (acute and chronic pancreatitis) were obtained from national health registers. The incidence rate ratio (IRR) of developing AP and CP increased with decreasing family income. Compared to participants in the highest income quintile, participants in the lowest income quintile had 43 (95% CI: 14-80%), 99 (95% CI: 26-214%), and 56% (95% CI: 26-94%) higher incidence rates of AP, CP, and all pancreatitis, respectively. The associations persisted after adjustment for alcohol intake, smoking, BMI, and diet.Likewise, participants with only primary school education had an IRR for an AP of 1.30 (95% CI: 1.06-1.59) compared to those with higher education after adjustment for baseline year, age, and sex. We found no interactions between alcohol intake and income or between alcohol intake and education in relation to neither AP, CP, nor all pancreatitis. This large prospective population study showed a significant social disparity in incidence rates of pancreatitis by family income, with higher rates among those with the lowest income and education independent of risk factors such as alcohol intake, smoking, BMI, and diet.

Risk factors for pancreatitis occurrence after gallstone treatment using endoscopic retrograde cholangiopancreatography.

Patients with gallstones are prone to pancreatitis after treatment using endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to explore the risk factors for pancreatitis occurrence after gallstone treatment using ERCP. A total of 193 patients treated from October 2017 to October 2020 were assigned into pancreatitis group (n=55) and non-pancreatitis group (n=138). Multivariate logistic regression analysis was utilized to analyse the risk factors for post-ERCP pancreatitis. The discrimination and accuracy of an established nomogram model were evaluated using receiver operating characteristic and calibration curves, respectively. The incidence rate of pancreatitis was 28.50% (55/193). Young age, long course of disease, gallbladder wall thickness >3 mm, sand-like stones, history of pancreatic disease, number of intubation ≥2 and absence of pancreatic duct stenting were risk factors for post-ERCP pancreatitis (P<0.05). The established model had high discrimination and accuracy. The incidence rates of pancreatitis in patients with and without pancreatic duct stenting were 11.84% (9/76) and 39.31% (46/117), respectively. The patients undergoing pancreatic duct stenting had lower serum amylase levels 6, 12 and 24 h after ERCP than those of patients who did not. Patients with gallstones have a higher risk of developing pancreatitis. Young age, long course of disease, gallbladder wall thickness >3 mm, sand-like stones, history of pancreatic disease, pancreatic duct visualization and number of intubation ≥2 are risk factors for post-ERCP pancreatitis.

Changes in the Incidence Rates of Gastrointestinal Diseases Due to the COVID-19 Pandemic in South Korea: A Long-Term Perspective.

We investigated whether the coronavirus disease 2019 (COVID-19) pandemic, in conjunction with public health measures, influenced the incidence of gastrointestinal diseases according to age and sex during the pandemic. Changes in the monthly incidence rates (January 2018 to June 2021) of common gastrointestinal diseases were assessed using data from the Korean National Health Insurance Service by comparing the data of two periods: before COVID-19 (January 2018–February 2020) and during COVID-19 (March 2020–June 2021). The Mann–Whitney U test and Levene’s test were used to compare the differences in the incidences before and during the pandemic. In the pandemic period, compared to in the pre-COVID-19 period, the incidence rates of ulcerative colitis, Crohn’s disease, cholelithiasis, and esophageal reflux significantly increased, whereas those of infective enteritis and irritable bowel syndrome decreased, regardless of age or sex. There were no significant changes in the incidence rates of pancreatitis, acute appendicitis, liver cirrhosis, and hemorrhoids. No seasonal variations in gastrointestinal disease occurrence were observed. In conclusion, the COVID-19 pandemic may have had unprecedented and long-term impacts on the epidemiology of gastrointestinal disease. These changes may indicate a substantial future burden on healthcare resources during the recovery phase of the pandemic and thereafter.

S1614 Idiopathic Pancreatitis, Newly Diagnosed Diabetes Mellitus I, and Hypothyroidism in a Young Patient With Recent COVID-19 Infection

Introduction: We present a young male who was diagnosed with pancreatitis, found to have diabetic ketoacidosis, and later diagnosed with hypothyroidism. Our case presents the relationship between COVID-19 and autoimmunity. Coronavirus has been linked to autoimmune diseases. Pancreatic involvement in autoimmunity is poorly studied. Pancreatic involvement in autoimmunity is poorly studied. Case Description/Methods: The patient is a 22-year-old male who presented to ER with nausea, vomiting, and abdominal pain. He reported a recent COVID-19 pneumonia. Pertinent history included weight loss, polyuria, polydipsia, for the 3 months. Vital signs were normal. Oxygen saturation was normal. Physical exam showed epigastric tenderness. Labs were consistent with ketoacidosis. Lipase was 2,322 Units/L, triglycerides were 387 mg/dL, hemoglobin A1c of 10.7%. Patient was on an insulin drip and intravenous hydration. TSH found to be 11.7 mUnits/L. Free T4 and free T3 were at 0.4 ng/dL and 0.8 pg/mL, respectively. Patient was discharged on levothyroxine and insulin. On further evaluation, C-peptide level was 0.3 ng/mL. Glutamic acid decarboxylase and thyroid peroxidase antibodies were positive, confirming the diagnosis of type I diabetes and thyroiditis. Discussion: Covid 19 affects the respiratory tract, gastrointestinal involvement has been reported. The patient's pancreatitis and thyroiditis could have been due to direct cytopathic effects of SARS-COV-2 replication, or indirectly by systemic immune response. In a case series of 52 patients with COVID-19, serum lipase was found elevated in 17% of patients without symptoms. Another case series of 67 patients with COVID-19 pneumonia, reported a 17% incidence rate of pancreatitis, although only 7% of patients had significant pancreatic damage. Regarding thyroidal disease, direct damage causes subacute thyroiditis. As the disease process progresses, hypothyroidism may last, especially in those with avidity to autoimmune disease. Type I diabetes may arise in patients who have the antibodies, especially after a viral infection. In rare cases, the virus can infect the islet cells directly and destroy them permanently. Coxsackie virus has been studied in connection to developing type I diabetes, due to molecular mimicry. This phenomenon is poorly studied in covid-19 but it would be of no surprise if it is present. It would be beneficial to monitor for autoimmune processes in patients who survived coronavirus disease as such processes can increase their morbidity if left unrecognized.

Effect of preventive closure of the frenulum after endoscopic papillectomy: A prospective pilot study.

The usefulness of preventive closure of the frenulum after endoscopic papillectomy (EP) could reduce bleeding. The feasibility and safety of clipping were evaluated in this prospective pilot study. This study involved 40 consecutive patients who underwent preventive closure of the frenulum by clipping just after EP. The outcome data were compared with those of the previous 40 patients in whom no preemptive closure had been performed (no-closure group) (UMIN000014783). Additionally, the bleeding sites were examined. The clipping procedure was successful in all patients. As compared to the no-closure group, the rate of bleeding (P=0.026) and period of hospital stay (P<0.001) were significantly reduced in the closure group. There was no difference in the procedure time between the two groups. Furthermore, the incidence rates of pancreatitis and perforation were comparable in the two groups. The bleeding was noted in the frenulum area rather than at any other site in 90.9% of cases. Preventive closure of the frenulum after EP is an effective, safe, rational, and economical method to reduce the incidence of delayed bleeding, without prolonging the procedure time or increasing the risk of post-procedure pancreatitis perforation.

Single-Operator Wire-Guided Cannulation Technique for Endoscopic Retrograde Cholangiopancreatography.

BackgroundThe aim of this prospective study was to evaluate the clinical application value of single-operator cannulation technology (SOCT) for endoscopic retrograde cholangiopancreatography (ERCP).Material/MethodsSixty-nine patients prepared for ERCP were prospectively recruited from February 2014 to January 2017 in the 4th People’s Hospital of Jinan. The included 69 patients were randomly divided into an experiment group (n=36) and a control group (n=33). Patients in the experiment group underwent SOCT procedure of ERCP and patients in the control group received the regular procedure of ERCP. The cannulation time, number of cannulations, number of attempts at cannulation, and ERCP procedure-relevant complications were recorded and compared between the 2 groups.ResultsAll of the included 69 patients successfully finished the ERCP procedure, with no peri-operative deaths. The median duration of cannulation for the experiment group was 7.4 (2.3~35.1) min and 7.1 (2.9~26.1) min for the control group, with no significant difference (p>0.05). The distribution of different cannulation periods and cannulation attempts were not significantly different between the 2 groups (p>0.05). The major complications relevant ERCP procedure were pancreatitis and infection. The incidence rate of pancreatitis and infection were 2.8% and 2.8% in the experiment group and 3.0% and 0.0% in control group, and the difference between groups was not significant (p>0.05).ConclusionsCompared with regular ERCP, SOCT achieved the same effects without the help of an experienced assistant, which could make the procedure useful in primary hospitals.

Simvastatin is associated with reduced risk of acute pancreatitis: findings from a regional integrated healthcare system

ObjectiveTo characterise the relationship between simvastatin and risk of acute pancreatitis (AP).DesignWe conducted a retrospective cohort study (2006–2012) on data from an integrated healthcare system in southern California. Exposure to...

The Incidence and Case-fatality Rates of Acute Biliary, Alcoholic, and Idiopathic Pancreatitis in California, 1994-2001

To better define the epidemiology of acute pancreatitis in a racially diverse population. Analysis of all patients hospitalized in California with first-time acute pancreatitis for the period between January 1994 and September 2001. Subtypes were classified based on the presence or absence of predisposing conditions. There were 70,231 patients hospitalized for first-time acute pancreatitis; 32.6% had biliary tract disease alone, 20.3% had alcohol abuse alone, and 36.6% were idiopathic. The age-standardized incidence increased by 32% from 33.2 to 43.8 cases per 100,000 adults for the period between 1994 and 2001, with the largest increase in the biliary group (52%). The standardized incidence rate of alcoholic and idiopathic pancreatitis was highest in African Americans, whereas biliary pancreatitis was highest in Hispanics. There was no change over time in the percentage of patients dying in the first 14 or 91 days; and in a risk-adjusted model, patients with alcoholic pancreatitis had the highest risk of dying. The incidence rate of acute pancreatitis rose for the period between 1994 and 2001. However, there was no reduction in the 14- or 91-day case-fatality rate. Further research is needed to explain both the rise in the incidence rate of pancreatitis and the absence of any improvement in the early case-fatality rate.