Akca Serdar, Ocal Serkan, Koc Sevgi Gulsen, Kaya Recep, Buldukoglu Osman Cagin, Koker Gokhan, Atar Galip Egemen, Harmandar Ferda Akbay, Cekin Ayhan Hilmi
Department of Gastroenterology, Antalya Training and Research Hospital, Antalya, Turkey.
Antalya Egitim ve Arastirma Hastanesi, Gastroenteroloji, Varlik mah. Kazim Karabekir Cd, Antalya, 07100, Turkey.
BMC Gastroenterol. 2025 Aug 30;25(1):627. doi: 10.1186/s12876-025-04240-z.
Acute pancreatitis (AP) is a common and potentially severe inflammatory condition of the pancreas with a heterogeneous etiology influenced by geographic, demographic, and lifestyle factors. This study aimed to evaluate the distribution of AP etiologies and their associations with age and sex in a regional cohort from a tertiary center.
This retrospective observational study included 445 adult patients hospitalized with a first episode of AP between January 2022 and October 2023. Data on demographics, etiology, severity (revised Atlanta classification), hospital course, and outcomes were extracted from medical records. Etiologies were classified as biliary, idiopathic, alcohol-related, drug-induced, hypertriglyceridemia (HTG), neoplasm-associated, or other miscellaneous causes. Age was grouped into five categories, and statistical analyses assessed the association between etiologies and demographic variables.
The median age was 65 years (range: 18-97), and 52.1% were female. Biliary etiology was the most frequent (66.1%), followed by idiopathic (9.4%), alcohol-related (7.0%), drug-induced (6.5%), neoplasm-associated (4.3%), and HTG-induced (3.1%). Females were significantly older than males (median 67 vs. 60 years, p < 0.001). Alcohol-related AP (AAP) was more common in males, particularly under age 55. Notably, among biliary AP (BAP) patients, males predominated in those under 55 (p = 0.02). Etiological patterns varied significantly by age. In patients aged ≥ 75 years, BAP was markedly more common (80.4% vs. 61.8%), whereas alcohol, drug, and HTG-related etiologies were rare. Severity of AP correlated with age and length of stay but not with etiology.
Biliary pancreatitis remains the predominant etiology in this region, especially among elderly patients. A novel finding of male predominance in younger BAP cases warrants further investigation. These data underscore the importance of regional age and sex specific approaches to AP prevention and management.
急性胰腺炎(AP)是一种常见且可能严重的胰腺炎症性疾病,其病因具有异质性,受地理、人口统计学和生活方式因素影响。本研究旨在评估一个三级中心区域队列中AP病因的分布及其与年龄和性别的关联。
这项回顾性观察研究纳入了2022年1月至2023年10月期间因首次发作AP而住院的445例成年患者。从病历中提取了人口统计学、病因、严重程度(修订的亚特兰大分类)、住院病程和结局等数据。病因分为胆源性、特发性、酒精相关性、药物性、高甘油三酯血症(HTG)、肿瘤相关性或其他杂项原因。年龄分为五类,统计分析评估病因与人口统计学变量之间的关联。
中位年龄为65岁(范围:18 - 97岁),女性占52.1%。胆源性病因最为常见(66.1%),其次是特发性(9.4%)、酒精相关性(7.0%)、药物性(6.5%)、肿瘤相关性(4.3%)和HTG诱导性(3.1%)。女性明显比男性年龄大(中位年龄67岁对60岁,p < 0.001)。酒精相关性AP(AAP)在男性中更常见,尤其是在55岁以下。值得注意的是,在胆源性AP(BAP)患者中,55岁以下男性占主导(p = 0.02)。病因模式随年龄有显著差异。在75岁及以上患者中,BAP明显更常见(80.4%对61.8%),而酒精、药物和HTG相关病因罕见。AP的严重程度与年龄和住院时间相关,但与病因无关。
胆源性胰腺炎仍然是该地区的主要病因,尤其是在老年患者中。年轻BAP病例中男性占主导这一新颖发现值得进一步研究。这些数据强调了针对AP预防和管理采取区域年龄和性别特异性方法的重要性。