Tendencies and outcomes in endoscopic biliary sphincterotomies among people with or without type 2 diabetes mellitus in Spain, 2003-2013

  1. José María de Miguel Yanes 3
  2. Manuel Méndez Bailón 1
  3. Rodrigo Jiménez García 2
  4. Cecilia González Asanza 3
  5. Valentín Hernández Barrera 2
  6. Nuria Muñoz Rivas 4
  7. Ana López de Andrés 2
  1. 1 Hospital Clínico San Carlos. Madrid, España
  2. 2 Rey Juan Carlos University. Alcorcón, Madrid. España
  3. 3 Hospital General Universitario Gregorio Marañón. Madrid, España
  4. 4 Hospital Infanta Leonor. Madrid,España
Revista:
Revista Española de Enfermedades Digestivas

ISSN: 2340-416 1130-0108

Año de publicación: 2016

Volumen: 108

Número: 7

Páginas: 386-393

Tipo: Artículo

DOI: 10.17235/REED.2016.4276/2016 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Revista Española de Enfermedades Digestivas

Resumen

We aimed to compare incidence and outcomes for endoscopic biliary sphincterotomies in people with or without type 2 diabetes mellitus (T2DM) in Spain (2003-2013). We collected all cases of endoscopic biliary sphincterotomies using national hospital discharge data and evaluated annual incidence rates stratified by T2DM status. We analyzed trends over time for in-hospital mortality (IHM) as the primary outcome and a composite of IHM or procedure-related complications (key secondary outcome). In multivariate analyses, we tested T2DM as an independent factor of IHM and IHM or complications. We identified 126,885 endoscopic biliary sphincterotomies (23,002 [18.1%] in T2DM people). Crude incidence rates of endoscopic biliary sphincterotomies were > 3-fold higher in people with vs without T2DM (85.5/105 vs 26.9/105 population, respectively). Annual incidence rates of endoscopic biliary sphincterotomies showed 11-year relative increments of 77.5% (from 60.0 to 106.5/105) in T2DM, and 53.7% (from 21.6 to 33.2/105) in non-T2DM people (p < 0.001). We found no significant changes in mortality trends over time for the populations with or without T2DM (p = 0.15 and p = 0.21, respectively). Rates of procedural pancreatitis decreased in people without T2DM (p < 0.001). In the multivariate analysis, older age, higher comorbidity and endoscopic biliary sphincterotomy during urgent admission were associated with a higher IHM. T2DM was associated with a lower IHM after an endoscopic biliary sphincterotomy (OR = 0.82 [0.74-0.92]). Time trend multivariate analyses 2003-2013 showed significant reductions in IHM over time only in people with T2DM (OR = 0.97 [0.94-1.00]). Further studies are needed to confirm a lower IHM for endoscopic biliary sphincterotomies in people with T2DM.