Clinical Assistant-Hospitalist Cleveland Clinic Foundation Cleveland, OH
George Khoudari, MD1, Ahmed Eltelbany, MD, MPH1, Mohammed Talal Sarmini, MD2, Motasem Alkhayyat, MD1, Yasser Alkhadra, MD1, Kenneth J. Vega, MD3, Madhusudhan R. Sanaka, MD1; 1Cleveland Clinic Foundation, Cleveland, OH; 2Cleveland Clinic Foundation, Avon Lake, OH; 3Augusta University Medical College of Georgia, Augusta, GA
Introduction: Idiopathic acute pancreatitis (IAP) accounts for a considerable number of emergency room visits and subsequent hospitalization. The rate and cost readmissions due to AIP is not well known. Therefore, we sought to study the causes and predictors of 30-day readmissions after an index admission with IAP. Methods: Using the National Readmission database (NRD) from 2016, we identified all patients admitted with IAP using ICD-10 codes. We then evaluated the causes and predictors of 30-day readmission using multivariable logistic regression analysis. Results: A total of 11,517 patients (mean age 52.58 years, 58% women) were diagnosed with IAP at index admission. The most common associated comorbidities were fluid and electrolytes disorders (41.8%), followed by hypertension (40%), iron deficiency anemia (21.6%), depression (20.3%), chronic lung diseases (20.3%) and renal failure (18%). The median length of stay for the cohort was 4 days. The 30-day readmission rate post-IAP index admission was 15.4%. Unspecified acute pancreatitis and IAP comprised the majority of causes for readmission, 22% and 14.5%, respectively. These are followed by sepsis (5.2%), pulmonary disease (3.8%), diabetes mellitus (3.5%), and cardiac disease (3%). The risk of all-cause 30-day readmission was not statistically different based on gender (p=0.8). Meanwhile, it was higher in patients with anemia, gastrointestinal bleeding, weight loss, renal failure, chronic pulmonary disease, diabetes mellitus, depression and drug abuse (P< 0.05 for all). The median cost of 30-day readmissions was $8075.80. Discussion: The rate of 30-day readmissions after IAP is high especially in those with associated comorbidities. These readmissions were associated with significant health care costs. Unspecified acute pancreatitis and IAP were among the two most common causes of readmissions. Our study findings have important clinical implications and might be helpful in developing strategies to decrease readmissions and health care costs.
Figure 1 Causes of 30 days readmission in IAP
Disclosures: George Khoudari indicated no relevant financial relationships. Ahmed Eltelbany indicated no relevant financial relationships. Mohammed Talal Sarmini indicated no relevant financial relationships. Motasem Alkhayyat indicated no relevant financial relationships. Yasser Alkhadra indicated no relevant financial relationships. Kenneth Vega indicated no relevant financial relationships. Madhusudhan Sanaka indicated no relevant financial relationships.