Published online Jun 20, 2023. doi: 10.5662/wjm.v13.i3.118
Peer-review started: March 24, 2023
First decision: April 27, 2023
Revised: May 4, 2023
Accepted: June 6, 2023
Article in press: June 6, 2023
Published online: June 20, 2023
Processing time: 87 Days and 16.7 Hours
Acute pancreatitis (AP) is a global burden, especially in Eastern Europe and former Soviet space. Romania although is part of Eastern Europe lacks quality epidemiological studies regarding the topics we aim in this study, like: Estimation of incidence, stratification of: Etiology, severity, outcome, morphology, estimation of cost regarding hospitalization of AP and tobacco usage prevalence in our country regarding AP cases.
From this study we aim to estimate the incidence, cost and tobacco usage in hospitalized AP cases and to upgrade and update former knowledge regarding: Etiology, severity, outcome, morphology of AP. Once this aim is fulfilled the data from this paper should be of use for: Medical practitioners from our country and countries that have large Romanian diaspora, medical researchers and healthcare policymakers from our country or any other international organization with a focus on this topic.
Main objective: Estimating the incidence was fulfilled although we were able to do that only in regard to southern Romania. Secondary objectives achieved: First estimation of AP costs in our country, first attempt to find the prevalence of tobacco usage in AP in our country. Also, we were able to update the knowledge regarding stratification. This study should be of use for a nationwide metanalysis of smaller regional studies or for a European or international metanalysis regarding this topic. This study should be also expanded with surgical patients.
Cases drawn from BUCharest - Acute Pancreatitis Index cohort of AP and Acute-on-Chronic Pancreatitis cases, which to the best of our knowledge is the largest analysed in Romania to this date. The entire team that worked on this study, did that remotely due to coronavirus disease 2019 pandemic restriction with the help of several online applications like: Adobe Reader, Microsoft 365 (formerly known as Microsoft Excel), Google Teams, Zoom, SPSS statistical package. We analysed data from Electronic Health Records of our facility, based on International Classification of Diseases (ICD)-10 coding of diagnostics. For the statistical analysis we used IBM SPSS v. 29.0.0.0 and we run the following tests depending on the type of variable of interest: Crosstab analysis, frequency analysis, χ2 test.
We managed to show that AP incidence total annual cost in Romania might be overestimated as stated in Global Burden of Disease study 2019 (no other recent data publicly available), this should be of great interest for healthcare policy makers in our country or other international organization interested by this topic. In the selection of cases, we also observed that ICD-10 does not have a particular code for Acute-on-Chronic Pancreatitis, this was a limitation that was dealt trough authors screening and exclusion but we consider that a code for this particular situation would be of great necessity.
Our study proposes a first, as far we know, estimation regarding costs of AP in our country and also a first glance, to the best of our knowledge, regarding tobacco usage prevalence in this disease. We also managed to make a reasonable first, as far as we know, grassroots estimation of incidence of AP in our region based on the data we have at this moment.
We seek in a near future to expand this study also on surgical cases and territorially as a multicentric study to be able to better estimate the current status of AP outside southern Romania.