Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院...

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Transcript of Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院...

Page 1: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Risk factors of acute pancreatitis: An ethnic difference

2015/03/30

埔里基督教醫院不分科住院醫師

何御彰

Page 2: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Introduction

Increasing incidence rate of acute pancreatitis 4 to 70 per 100,000 population

Pancreas 2014,43:1117-1122

Increases by an annual average of 1 to 5%Pancreas 2012,41:696-702

Risk factor of acute pancreatitis Cigarette smoking in Western countries

Am J Epidemiol 2008,168:932-937

Arch Intern Med 2008,168:649-656

Alcohol drinking in TaiwanPancreas 2014,43:1117-1122

Page 3: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Introduction

Study from Australia Higher rate of alcohol-related acute pancreatitis

Aust J Rural Health 2001,9:134-137

The aim of the study To investigate the differences in risk factors between Taiwanese

aborigines and non-aborigines

Page 4: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Materials and Methods

Participants Recruitment

Puli Christian Hospital (PCH) January, 2006 to December, 2014 International Classification of Diseases 577.0

Exclusion Re-admission Nationality other than Republic of China

Page 5: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Materials and Methods

Demographic characteristics Age / Gender / Body mass index

Social habitus Alcohol drinking / Betel nut chewing / Cigarette smoking

Biochemical properties Amylase / Lipase / Triglyceride / Uric acid / Calcium

Risk factors Alcohol-related / Gallstone / Hypertriglyceridemia Distal CBD obstruction / Hypercalcemia / Unknown

Page 6: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Materials and Methods

Statistical analysis Two tailed unpaired student’s t test

Age / BMI Amylase / Lipase / Triglyceride / Uric acid / Calcium

Pearson’s chi-squared test and Fisher’s exact test Gender Habitus Risk factor of acute pancreatitis

Page 7: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Result

Page 8: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Result

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Result

Page 10: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Discussion

Demographic characteristics & Social habitus Aborigines

Younger Higher female-to-male ratio More habitus of alcohol drinking

Major issue of public health in Taiwanese aborigines More readily accessibility to alcohol Stress of marital life

Alcohol Clin Exp Res 1995,19:81-91

Soc Psychiatry Psychiatr Epidemiol 2013,48:955-963

Page 11: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Discussion

Biochemical properties Aborigines

Higher uric acid level Possible explanation

More alcohol consumption More vulnerability of hyperuricemia at a genetic level

Am J Hum Genet 2004,75:498-503

Higher uric acid level in smoking patients with pancreatitisPrzegl Lek 2013,70:809-812

Page 12: Risk factors of acute pancreatitis: An ethnic difference 2015/03/30 埔里基督教醫院 不分科住院醫師 何御彰.

Discussion

Risk factors Aborigines

More alcohol-related acute pancreatitis Culturally adapted intervention

Motivational care planningAust J Rural Health 2009,17:174-182

General practitioners trainingAust J Rural Health 2013,21:72-79

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Discussion

Limitation Inadequate information of alcohol drinking Lack of easily medical accessibility Critical condition with immediate referral Extensive risk factor surveys were not conducted for everyone

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Conclusion

Taiwanese aborigines are more susceptible to alcohol-related pancreatitis than non-aborigines.

The importance of public health education and effective strategy to prevent them from alcoholism cannot be overemphasized

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