Rutgers New Jersey Medical School
Systemic lupus erythematosus is known as a rare cause of acute pancreatitis, but the effects of concomitant SLE on outcomes of acute pancreatitis have not been well described. We aim to assess the outcomes of acute pancreatitis in patients with concomitant SLE.
Patients hospitalized with acute pancreatitis from the National Inpatient Sample (NIS) database in the year 2014 were selected. Diagnoses were identified by using ICD-9 CM codes. Patient demographics and outcomes of acute pancreatitis were compared between the groups with and without SLE. Multivariate logistic regression analysis was performed to compare the outcomes. The outcomes of interest were inpatient mortality, respiratory failure, acute renal failure, MI, hypotensive shock, sepsis, stroke, and ileus. Outcomes were adjusted for age, sex, race, Elixhauser Comorbidity Index, and etiologies of pancreatitis such as cholelithiasis, alcohol abuse, hypertriglyceridemia, obstruction of bile duct, and hypercalcemia.
Among 434,280 patients with acute pancreatitis identified in the study, 3,015 patients had SLE. Among patients hospitalized with acute pancreatitis, those with SLE were younger (48.0 vs 53.5, p < 0.05), more likely to be female (89.5% vs. 51.6%, p < 0.05), more likely to be non-White (48.0% vs. 65.7%, p < 0.05), had higher Elixhauser Comorbidity Index (7.5 vs. 5.7, p < 0.05), and stayed longer in the hospital (6.9 days vs. 5.7 days, p < 0.05). Patients without SLE were more likely to have history of cholelithiasis (21.5% vs. 14.8%, p < 0.05), alcohol abuse (12.7% vs. 4.8%, p < 0.05), and hypertriglyceridemia (4.7% vs. 0.3%, p < 0.05). After adjusting for potential confounding factors, patients with SLE had higher rates of inpatient mortality (OR 1.88, 95% CI: 1.52-2.33, P < 0.05), respiratory failure (OR 1.44, 95% CI: 1.24-1.67, P < 0.05), acute renal failure (OR 1.44, 95% CI: 1.30-1.59, P < 0.05), hypotensive shock (OR 1.54, 95% CI: 1.34-1.76, P < 0.05), stroke (OR 2.14, 95% CI: 1.43-3.21, P < 0.05), and sepsis (OR 1.33, 95% CI: 1.17-1.51, P < 0.05). Rates of MI (1.7% vs. 1.7%, p = 0.81) and ileus (OR 0.94, 95% CI: 0.75-1,16, P = 0.55) were not significantly different.
Discussion: Our study indicates that patients hospitalized with acute pancreatitis with concomitant SLE have higher rates of inpatient mortality, respiratory failure, acute renal failure, hypotensive shock, stroke, and sepsis, which should be considered when providing care to the patients with concomitant SLE.
Daniel Rim indicated no relevant financial relationships.
Catherine Choi indicated no relevant financial relationships.
Yi Jiang indicated no relevant financial relationships.
Sushil Ahlawat indicated no relevant financial relationships.