title: Effects of proton pump inhibitor on outcomes of patients with severe acute pancreatitis based on a national administrative database.
abstract: OBJECTIVE
  This study aimed to investigate whether proton pump inhibitors (PPIs) affect the outcomes of patients with severe acute pancreatitis based on a national administrative database.
  
  
  METHODS
  A total of 10,400 patients with severe acute pancreatitis were referred to 1021 hospitals between 2010 and 2012 in Japan. Patients were divided into two groups: patients who used PPIs (n = 3879) and those without PPIs (n = 6521). We collected patients' data from the administrative database to compare in-hospital mortality within 7, 14, and 28 days, and overall in-hospital mortality between groups, using propensity score analysis to adjust for treatment selection bias.
  
  
  RESULTS
  Multiple logistic regression showed that use of PPIs did not affect in-hospital mortality within 7 and 14 days. The odds ratio (OR) for mortality within 7 days was 1.14 (95% confidence interval [CI]: 0.91-1.42, p = 0.236) while that within 14 days was 1.10 (95% CI: 0.89-1.35, p = 0.349). No significant association was observed for in-hospital mortality within 28 days and overall in-hospital mortality (OR for within 28 days: 1.12, 95% CI: 0.92-1.37, p = 0.224; OR for overall in-hospital mortality: 1.42, 95% CI: 0.97-1.87, p = 0.065).
  
  
  CONCLUSIONS
  This study shows that use of PPIs does not affect clinical outcomes of patients with severe acute pancreatitis. Prospective or randomized studies are needed to confirm the efficacy of PPIs on outcomes of patients with severe acute pancreatitis in the future.
authors: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. Electronic address: amurata@med.uoeh-u.ac.jp.
authors: Atsuhiko
authors: A
authors: Murata
authors: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors: Makoto
authors: M
authors: Ohtani
authors: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors: Keiji
authors: K
authors: Muramatsu
authors: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors: Shinya
authors: S
authors: Matsuda
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000188:drug therapy* / Q000401:mortality; D057216:Propensity Score; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors
keywords: Database; Mortality; Observational study; Outcomes; Proton pump inhibitors; Severe acute pancreatitis