Rutgers New Jersey Medical School Newark, NJ, United States
Amjad Shaikh, MD, Mohamad Aghaie Meybodi, MD, Mohsin Ali, MD, Sushil Ahlawat, MD Rutgers New Jersey Medical School, Newark, NJ
Introduction: Recent data suggests that early re-feeding may be improve outcomes in patents with pancreatitis. However, to our knowledge, there is no large database study examining the effects of preexisting malnutrition on patients admitted for acute pancreatitis. Here, we present a study using the Nationwide Inpatient Sample.
Methods: Data between 2008 and 2014 from the Nationwide Inpatient Sample database was extracted. Inclusion criteria for both groups included patients with a primary diagnosis of acute pancreatitis using International Classification of Diseases, 9th Revision codes and age greater than 17. Exclusion criteria included all ICD-9 codes for chronic pancreatitis. The study group consisted of patients with a primary diagnosis of acute pancreatitis and a concurrent diagnosis of malnutrition. In-hospital mortality and various comorbidities were compared between the two groups. Univariate and multivariate analyses were used to generate odds ratios. Elixhauser Comorbidity scores predicting mortality and readmission were calculated based on weighted scores from 29 different co-morbidities. Scores were compared between the two groups using univariate analysis.
Results: There were a total of 1849162 patients in the control group and 102056 patients int he study group for hospitals in the United States between 2008 and 2014. There was a significant difference in hospital mortality between the study groups on univariate analysis. There was a significant difference (p < 0.05), with a higher mortality in patients with malnutrition. Patients with malnutrition also were found to develop sepsis, severe sepsis, septic shock, and respiratory at higher rates (3.7%, 4.2%, 2.5%, and 10.1% respectively, p < 0.05). In hospital mortality on multivariate analysis for the two groups was found not to be significant (p-0.88, OR = 1.004). Malnutrition patients had a significantly higher Elixhauser mortality (31.50 ± 14.66) and readmission (16.37 ± 9.67) scores as compared to patients without malnutrition mortality (3.70 ± 8.04) and readmission (14.10 ± 12.97) scores (p< 0.001), indicating a higher rate of co-morbidities.
Discussion: Patients with malnutrition appear to have higher rates of co-morbdites in patients admitted with acute pancreatitis. Likely, pre-existing malnutrition on admission is indicative of co-morbidities that worsen outcomes, as further evidenced by the significantly higher Elixhauser scores. Addressing malnutrition by optimizing nutritional status early on in admission may improve outcomes.
Amjad Shaikh: IDEXX – Employee.
Mohamad Aghaie Meybodi indicated no relevant financial relationships.
Mohsin Ali indicated no relevant financial relationships.
Sushil Ahlawat indicated no relevant financial relationships.
Amjad Shaikh, MD, Mohamad Aghaie Meybodi, MD, Mohsin Ali, MD, Sushil Ahlawat, MD. P1080 - Malnutrition Imparts Worse Outcomes in Patients Admitted for Acute Pancreatitis: An NIS Database Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.