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慢性胰腺炎患者胰腺外分泌功能不全治疗与管理的欧洲指南依从性

Adherence to European Guidelines for Treatment and Management of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis Patients.

作者信息

Khan Mashroor, Rutkowski Wiktor, Vujasinovic Miroslav, Löhr Johannes Matthias

机构信息

Department of Medicine Huddinge, Karolinska Institutet, Huddinge, SE-141 86 Stockholm, Sweden.

Department of Upper Abdominal Diseases, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden.

出版信息

J Clin Med. 2021 Jun 21;10(12):2737. doi: 10.3390/jcm10122737.

Abstract

European evidence-based guidelines for the treatment and management of chronic pancreatitis (CP) have been made available following the harmonizing diagnosis and treatment of CP across Europe (HaPanEU) initiative by the United European Gastroenterology (UEG). The aim of this study was to evaluate adherence to the guideline recommendations in the management of patients with pancreatic exocrine insufficiency (PEI) at Karolinska University Hospital in Stockholm. UEG guideline recommendations were evaluated and categorized into 55 different quality indicators (QIs). Data from a retrospective cohort of CP patients being treated at Karolinska University Hospital were evaluated with regard to overall adherence as well as adherence to specific QIs. A total number of 118 patients out of 956 patients diagnosed with CP were eligible for inclusion with mean overall adherence of 61.9% to the defined QIs. A significant difference in mean overall adherence was shown between patients diagnosed with CP prior to 1 January 2016 and following 1 January 2016 (59.3% and 67.7% respectively, = 0.004), with linear regression analysis also demonstrating improvement correlating to date of diagnosis ( = 0.002). In conclusion, diagnosis and treatment of PEI improved after the HaPanEU guidelines became available and is continuously improving; however, there is room for further improvement.

摘要

在欧洲胃肠病学联合会(UEG)发起的全欧洲慢性胰腺炎(CP)诊断与治疗协调统一(HaPanEU)倡议之后,欧洲基于证据的慢性胰腺炎治疗与管理指南已发布。本研究的目的是评估斯德哥尔摩卡罗林斯卡大学医院对胰腺外分泌功能不全(PEI)患者管理中指南建议的遵循情况。对UEG指南建议进行评估并归类为55个不同的质量指标(QIs)。对卡罗林斯卡大学医院接受治疗的CP患者回顾性队列数据进行总体遵循情况以及对特定QIs遵循情况的评估。在956例诊断为CP的患者中,共有118例符合纳入标准,对既定QIs的平均总体遵循率为61.9%。2016年1月1日前诊断为CP的患者与2016年1月1日后诊断为CP的患者在平均总体遵循率上存在显著差异(分别为59.3%和67.7%,P = 0.004),线性回归分析也显示与诊断日期相关的改善情况(P = 0.002)。总之,HaPanEU指南发布后,PEI的诊断和治疗有所改善且持续改进;然而,仍有进一步改进的空间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1ed/8233716/714f224ef86e/jcm-10-02737-g001.jpg

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