West Virginia University, School of Medicine Morgantown, West Virginia
Fahad Chaudhary, MD, Ridwaan Albeiruti, MD; West Virginia University, School of Medicine, Morgantown, WV
Introduction: : Depression affects nearly 1 in 12 Americans and expected to increase over the next decade. Depression may have an adverse effect on clinical outcomes in patients with pancreatitis. In an effort to maintain the improvement of acute pancreatitis, we sough to evaluate the impact of depression on patients with pancreatitis using national inpatient data. Methods: The Nationwide Inpatient Sample (2003-2016) was used to identify all adult patients requiring inpatient hospitalization with a primary diagnosis of acute and chronic pancreatitis. Primary outcomes studied included morality, acute renal failure, acute respiratory failure, septic shock as well as secondary outcomes such as length of stay and hospital cost were analyzed using univariate and multivariate regressions. Results: From 2003-2016, the nation estimate for patients hospitalized with acute and chronic pancreatitis was 7,158,894. Of these, 508,282 (7.1%) patients carried a diagnosis of depression as well. Patients hospitalized for pancreatitis with depression were more likely to be under the age of 65 (87% vs 73%%, p< 0.001), female (52% vs 49%%, p< 0.001) and White (71% vs 64%, p< 0.001). The etiology of their pancreatitis was more likely to be Alcohol use (35% vs 23%, p< 0.001) than biliary and other causes. Depressed patients had a lower likelihood of mortality (1.2% vs 2.3%, p< 0.001) and needing endoscopic intervention (7.4% vs 9.9%, p< 0.001) during the hospitalization but were more likely to leave against medical advice (3.5% vs 2.0%, p< 0.001), have GI bleeding (3.6% vs 3.0%, p< 0.001), respiratory failure (5.2% vs 4.8%, p< 0.001) and AKI (12.1% vs 11.8%, p< 0.001). There were no differences in patient with and without depression when it came to outcomes such as septic shock, length of stay or total cost of hospitalization. Discussion: Patients with depression seem to have a lower likelihood of mortality and need for endoscopy intervention but are more likely to incur morbidities such as AKI, respiratory failure and GI bleeding while also being more prone to leave against medical advice. Further, randomized control trials are needed to elucidate the exact cause of these findings.
Disclosures: Fahad Chaudhary indicated no relevant financial relationships. Ridwaan Albeiruti indicated no relevant financial relationships.