P1047 - Chronic Pancreatitis in Emergency Departments in Association With Opioid Overdoses: National Emergency Department Sample (NEDS) Trends From 2009-2015

Eric M. Sieloff, MD¹, Alejandro Robles, MD², James D. Boyer, DO³, Cuyler Huffman, MS³, Serge Sorser, MD⁴, Thomas Melgar, MD^3
1Ascension Providence Hospital, Troy, MI; ²Texas Tech University Health Sciences Center, El Paso, TX; ³Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI; ⁴Ascension Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI

Introduction: Chronic pancreatitis is a condition that results from progressive inflammation and fibrosis of the pancreas that can result in endocrine and exocrine insufficiency. Patients with this disease can be afflicted with significant pain. There are several options for pain management, of which opioid therapy is the last line. More recently, the opioid epidemic is continuously worsening in the United States. We investigate trends in chronic pancreatitis (CP) visits in Emergency Departments (EDs) from 2009-2015 in associated with opioid overdoses (OOD).

Methods: Using the NEDS database for the years 2009, 2012 and 2015 we investigated three separate populations: 1) chronic pancreatitis without opioid overdose (CP without OOD), 2) chronic pancreatitis with opioid overdose (CP with OOD), and 3) opioid overdoses without chronic pancreatitis (OOD without CP). Both ICD9 and ICD10 codes were used to collect data for these years in order to investigate ED visits for each of these populations, along with patient demographics and hospital expenditures.

Results: For the years 2009, 2012 and 2015 there were a total of 193,901, 216,972 and 103,267 ED visits for CP without OOD, and 512, 643 and 148 ED visits for CP with OOD, respectively. For opioid overdoses without chronic pancreatitis, there were 120,545, 152,192, and 143,679 ED visits in the years 2009, 2012 and 2015, respectively. All visits for OOD with CP were with patients over the age of 18 years old, and the median age at ED visit was between 46.8-49.9 years old for each of the three years. The majority of OOD with CP visits were covered by Medicare insurance (31.24%-53.68%). As for opioid overdoses without chronic pancreatitis, the median age at ED visit was between 31.66-40.71 years old during the study years, and the majority of visits were covered by Medicaid insurance (23.87-39.66%).

Discussion: The number of ED visits for chronic pancreatitis with and without opioid overdoses increased from the year 2009 to 2012, and then decreased to the year 2015. This may suggest that we are developing more successful modalities to manage chronic pancreatitis with published guidelines following the year 2012. Further, the significant reduction in opioid overdoses in association with CP could suggest that physicians are adhering to conservative opioid prescribing for the disease based on guideline recommendations, driven by the national opioid epidemic.


Disclosures:
Eric Sieloff indicated no relevant financial relationships.
Alejandro Robles indicated no relevant financial relationships.
James Boyer indicated no relevant financial relationships.
Cuyler Huffman indicated no relevant financial relationships.
Serge Sorser indicated no relevant financial relationships.
Thomas Melgar indicated no relevant financial relationships.


Eric M. Sieloff, MD¹, Alejandro Robles, MD², James D. Boyer, DO³, Cuyler Huffman, MS³, Serge Sorser, MD⁴, Thomas Melgar, MD³. P1047 - Chronic Pancreatitis in Emergency Departments in Association With Opioid Overdoses: National Emergency Department Sample (NEDS) Trends From 2009-2015, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.