BACKGROUND AND AIM: Food access is an important social determinant of health and refers to geographical and infrastructural aspects of food availability. Using publicly available data on food access from the United States Department of Agriculture (USDA), geospatial analyses can identify regions with variable food access, which may impact acute pancreatitis (AP), an acute inflammatory condition characterized by unpredictable outcomes and substantial mortality. This study aimed to investigate the association of clinical outcomes in patients with AP with geospatial food access. METHODS: We examined AP-related hospitalizations at a tertiary center from January 2008 to December 2018. The physical addresses were geocoded through ArcGIS Pro2.7.0 (ESRI, Redlands, CA). USDA Food Access Research Atlas defined low food access as urban areas with 33% or more of the population residing over one mile from the nearest food source. Regression analyses enabled assessment of the association between AP outcomes and food access. RESULTS: The study included 772 unique patients with AP residing in Massachusetts with 931 AP-related hospitalizations. One hundred and ninety-eight (25.6%) patients resided in census tracts with normal urban food access and 574 (74.4%) patients resided in tracts with low food access. AP severity per revised Atlanta classification [OR: 1.88 (95%CI: 1.21-2.92); p=0.005], and 30-day AP-related readmission [OR: 1.78(95%CI: 1.11-2.86); p=0.02] had significant association with food access, despite adjustment for demographics, healthcare behaviors, and comorbidities (Charlson Comorbidity Index). However, food access lacked significant association with AP-related mortality (p=0.40) and length of stay (LOS: p=0.99). CONCLUSION: Low food access had a significant association with 30-day AP-related readmissions and AP severity. However, mortality and LOS lacked significant association with food access. The association between nutrition, lifestyle, and AP outcomes warrants further prospective investigation.

中文翻译：

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地理空间粮食获取对急性胰腺炎结果的影响

背景和目的：食物获取是健康的重要社会决定因素，涉及食物供应的地理和基础设施方面。利用美国农业部 (USDA) 公开的食物获取数据，地理空间分析可以识别食物获取情况变化的区域，这可能会影响急性胰腺炎 (AP)，这是一种以不可预测的结果和大量死亡率为特征的急性炎症性疾病。本研究旨在调查 AP 患者的临床结果与地理空间食物获取的关联。方法：我们检查了 2008 年 1 月至 2018 年 12 月期间在一家三级中心与 AP 相关的住院情况。通过 ArcGIS Pro2.7.0（ESRI，雷德兰兹，加利福尼亚州）对物理地址进行地理编码。美国农业部食品获取研究地图集将低食品获取定义为 33% 或更多人口居住在距最近食物来源超过一英里的城市地区。回归分析能够评估 AP 结果与食物获取之间的关联。结果：该研究纳入了居住在马萨诸塞州的 772 名独特的 AP 患者，其中 931 例与 AP 相关住院。198 名 (25.6%) 患者居住在城市食物供应正常的人口普查区，574 名 (74.4%) 患者居住在食物供应不足的地区。根据修订后的亚特兰大分类的 AP 严重程度 [OR：1.88 (95% CI：1.21-2.92)；p=0.005]，以及 30 天 AP 相关的再入院 [OR：1.78（95% CI：1.11-2.86）；尽管对人口统计、医疗保健行为和合并症（查尔森合并症指数）进行了调整，但 p=0.02] 与食物获取具有显着相关性。然而，食物获取与 AP 相关死亡率 (p=0.40) 和住院时间 (LOS: p=0.99) 缺乏显着关联。结论：食物获取不足与 30 天 AP 相关的再入院和 AP 严重程度显着相关。然而，死亡率和 LOS 与食物获取缺乏显着关联。营养、生活方式和 AP 结果之间的关联值得进一步的前瞻性研究。