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Vege SS, Yadav D, Chari S. Validation of the Distinct Entity "Chronic Pancreatitis Without Prior Acute Pancreatitis": Complementary Role of Population- and Clinic-Based Studies. Gastroenterology 2024; 166:1195-1196. [PMID: 38103841 DOI: 10.1053/j.gastro.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Affiliation(s)
- Santhi Swaroop Vege
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Dhiraj Yadav
- Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Suresh Chari
- Department of Gastroenterology, Hepatology and Nutrition, MD Anderson Cancer Center, Houston, Texas
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Chhoda A, McHenry N, Liyen Cartelle A, Bocchino R, Kahan T, Shah I, Zuberi SA, Anderson K, Freedman SD, Sheth SG. Impact of Ethno-racial Factors on Clinical Outcomes and Health Care Utilization in Chronic Pancreatitis. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02017-w. [PMID: 38702491 DOI: 10.1007/s40615-024-02017-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/17/2024] [Accepted: 04/28/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Healthcare disparities adversely affect clinical outcomes in racial and ethnic minorities. Chronic pancreatitis (CP) is a complex disorder, and pressures for time and cost-containment may amplify the disparity for minorities in this condition. This study aimed to assess ethno-racial differences in the clinical outcomes of CP patients cared for at our institution. METHODS This is a study of CP patients with available ethno-racial information followed at our pancreas center. We reviewed their demographics, comorbidities, clinical outcomes, and resource utilization: pain, frequent flares (≥ 2/year), local complications, psychosocial variables, exocrine, and endocrine insufficiency, imaging, endoscopic procedures, and surgeries. The outcomes underwent logistic regression to ascertain association(s) with covariates and were expressed as odds ratio (95% confidence intervals). RESULTS Of the 445 CP patients, there were 23 Hispanics, 330 Non-Hispanic Whites, 47 Non-Hispanic Blacks, 16 Asian Americans, and 29 patients from Other/mixed races. Over a median follow-up of 7 years, no significant differences in the pain profile (p = 0.36), neuromodulator use (p = 0.94), and opioid use for intermittent (p = 0.34) and daily pain (p = 0.80) were observed. Frequent flares were associated with Hispanic ethnicity [2.98(1.20-7.36); p = 0.02], despite adjustment for smoking [2.21(1.11-4.41); p = 0.02)] and alcohol [1.88(1.06-3.35); p = 0.03]. Local complications (pseudocysts, mesenteric thrombosis, and biliary obstruction), exocrine and endocrine dysfunction, and healthcare resource utilization (cross-sectional imaging, endoscopic procedures, celiac blocks, or surgeries) were comparable across all ethno-racial groups. CONCLUSIONS Although no significant differences in clinical outcomes, and health resource utilization were noted across ethno-racial groups, Hispanic ethnicity had significant association with CP flares. This study calls for further investigation of an understudied minority population with CP.
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Affiliation(s)
- Ankit Chhoda
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA
| | - Nicole McHenry
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA
| | - Anabel Liyen Cartelle
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA
| | - Rachel Bocchino
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA
| | - Tamara Kahan
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA
| | - Ishani Shah
- Division of Gastroenterology, University of Utah Hospital, Salt Lake City, USA
| | - Shaharyar A Zuberi
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA
| | - Kelsey Anderson
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA
| | - Steven D Freedman
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA
| | - Sunil G Sheth
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Rabb 423, Boston, MA, 02215, USA.
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Park SM, Kim KB, Han JH, Kim N, Kang TU, Swan H, Kim HJ. Incidence and risk of pancreatic cancer in patients with acute or chronic pancreatitis: a population-based cohort study. Sci Rep 2023; 13:18930. [PMID: 37919344 PMCID: PMC10622573 DOI: 10.1038/s41598-023-45382-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
We aimed to evaluate the incidence and risk of pancreatic cancer (PC) in pancreatitis. We identified patients with acute pancreatitis (AP) (n = 225,811, 50.0%) and chronic pancreatitis (CP) (n = 225,685, 50.0%) from Korean population-based data and matched them with age- and sex-matched controls (n = 4,514,960). We analyzed the incidence and adjusted hazard ratios (aHRs) of PC among patients followed for more than 2 years or 5 years, and assessed risk changes over time in single episode of AP (SAP), recurrent AP (RAP), CP with AP, and CP without AP groups. We also performed subgroup analysis for both sexes. The incidences (per 104 person-years) and risks (aHR) of PC were higher in the RAP (12.69, 5.00) or CP with AP (12.12, 5.74) groups compared to the SAP (2.31, 1.32) or CP without AP (2.28, 1.57) groups. The risks of PC decreased over time, however, the risk of PC remained elevated in the RAP and CP with AP groups for more than 8 years. Females with RAP, SAP, and CP with AP had higher risks of PC than males. The risk of PC is higher and persists for longer duration in patients with RAP and CP with AP compared to those with SAP or CP without AP.
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Affiliation(s)
- Seon Mee Park
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Ki Bae Kim
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Joung-Ho Han
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Nayoung Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seungnam, Republic of Korea
| | - Tae Uk Kang
- Health and Wellness College, Sungshin Women's University, Seoul, Republic of Korea
| | - Heather Swan
- Department of Preventive Medicine, Korea University College of Medicine, 126-1, 5-ga, Inchon-ro, Seoul, 136-705, Republic of Korea
| | - Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, 126-1, 5-ga, Inchon-ro, Seoul, 136-705, Republic of Korea.
- Department of Public Health, Graduate School, Korea University, Seoul, Republic of Korea.
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