Coexistent alcohol-related cirrhosis and chronic pancreatitis have a comparable phenotype to either disease alone:A comparative retrospective analysis  

作　　者：Michael Lu Yujie Sun Robert Feldman Melissa Saul Andrew Althouse Gavin Arteel Dhiraj Yadav 

机构地区：[1]Department of Medicine,University of Pittsburgh Medical Center,Pittsburgh,PA 15213,United States [2]Department of Medicine,Center for Research on Health Care Data,Pittsburgh,PA 15213,United States [3]Division of Gastroenterology,Hepatology,and Nutrition,University of Pittsburgh Medical Center,Pittsburgh,PA 15213,United States [4]Department of Medicine,Division of Gastroenterology,Hepatology and Nutrition,University of Pittsburgh Medical Center,Pittsburgh,PA 15213,United States

出　　处：《World Journal of Hepatology》2023年第3期431-440,共10页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Alcohol use disorder is a prevalent disease in the United States.It is a well-demonstrated cause of recurrent and long-standing liver and pancreatic injury which can lead to alcohol-related liver cirrhosis(ALC)and chronic pancreatitis(ACP).ALC and ACP are associated with significant healthcare utilization,cost burden,and mortality.The prevalence of coexistent disease(CD)ranges widely in the literature and the intersection between ALC and ACP is inconsistently charac-terized.As such,the clinical profile of coexistent ALC and ACP remains poorly understood.We hypothesized that patients with CD have a worse phenotype when compared to single organ disease.AIM To compare the clinical profile and outcomes of patients with CD from those with ALC or ACP Only.METHODS In this retrospective comparative analysis,we reviewed international classi-fication of disease 9/10 codes and electronic health records of adult patients with verified ALC Only(n=135),ACP Only(n=87),and CD(n=133)who received care at UPMC Presbyterian-Shadyside Hospital.ALC was defined by histology,imaging or clinical evidence of cirrhosis or hepatic decompensation.ACP was defined by imaging findings of pancreatic calcifications,moderate-severe pancreatic duct dilatation,irregularity or atrophy.We compared demographics,pertinent clinical variables,healthcare utilization,and mortality for patients with CD with those who had single organ disease.RESULTS Compared to CD or ACP Only,patients with ALC Only were more likely to be older,Caucasian,have higher body mass index,and Hepatitis B or C infection.CD patients(vs ALC Only)were less likely to have imaging evidence of cirrhosis and portal hypertension despite possessing similar MELD-Na and Child C scores at the most recent contact.CD patients(vs ACP Only)were less likely to have acute or recurrent acute pancreatitis,diabetes mellitus,insulin use,oral pancreatic enzyme therapy,and need for endoscopic therapy or pancreatic surgery.The number of hospitalizations in patients with CD were similar to ACP Only

关 键 词：ALCOHOL CIRRHOSIS Chronic pancreatitis OVERLAP PHENOTYPE 

分 类 号：R575.2[医药卫生—消化系统] R576[医药卫生—内科学]