Staten Island University Hospital, Northwell Health Staten Island, NY, United States
Harika Kandlakunta, MD1, Sri Harsha Patlolla, MBBS2, Sajan Nagpal, MD3 1Staten Island University Hospital, Northwell Health, Staten Island, NY; 2Mayo Clinic, Rochester, MN; 3University of Chicago, Chicago, IL
Introduction: Contemporary information on trends of acute pancreatitis (AP) related mortality is limited. Further, outcomes and resource utilization associated with various etiologies of AP remain understudied
Methods: We utilized the National Inpatient Sample database (January 2003-December 2017) to identify all adult hospitalizations with a primary diagnosis of AP, based on ICD-9 and ICD-10 codes. Admissions were then stratified into those with ‘biliary AP’, alcohol-related AP. and ‘other AP’ (non-biliary and non-alcohol related). Trends in prevalence and in-hospital mortality were assessed using the Mantel-Haenzsel test for trend. In-hospital mortality and resource utilization were compared between the sub-types of AP. A hierarchical logistic regression analysis was used to estimate adjusted outcomes accounting for age, sex, race, socioeconomic status, hospital characteristics, primary payer, and comorbidities (congestive heart failure, hypertension, diabetes, chronic lung and renal disease, liver disease and obesity).
Results: Between 2003 and 2017, there were a total of 3,929,460 hospitalizations for AP. Among these, 975,930 (24.8%) were identified as biliary AP, 972,568 (24.8%) as alcohol-induced AP, and the remaining 50.4% were classified as other AP hospitalizations. Over the study period, the relative proportion of biliary AP remained stable, whereas an increase in alcohol-induced AP and a decline in other AP hospitalizations was noted (Figure 1A). Overall in-hospital mortality was 0.9%, with an improvement noted from 1.5% in 2003 to 0.6% in 2017 (Ptrend< 0.001). After adjusting for available confounders , compared to biliary AP hospitalizations, those with alcohol-induced AP (OR 1.15 [95% CI 1.10-1.20]; P< 0.001) and other AP (OR 1.14 [95% CI 1.11-1.17]; P< 0.001) had higher in-hospital mortality. Hospitalizations for biliary AP had longer median lengths of hospital stay (4 days vs 3 days vs 3 days; P< 0.001) and higher hospitalization charges ($29,039 vs $17,382 vs $16,610; P< 0.001) compared to alcohol-induced AP and other AP hospitalizations respectively.
Discussion: While in-hospital mortality related to AP has continued to improve, the proportion of inpatients with alcohol-related AP has increased in recent years. Continued efforts to address alcohol dependence can help improve outcomes in patients with AP, especially because alcohol-related AP was associated with higher in-hospital mortality than biliary AP.
Harika Kandlakunta indicated no relevant financial relationships.
Sri Harsha Patlolla indicated no relevant financial relationships.
Sajan Nagpal indicated no relevant financial relationships.
Harika Kandlakunta, MD1, Sri Harsha Patlolla, MBBS2, Sajan Nagpal, MD3. P0025 - Trends in Mortality and Resource Utilization in Hospitalized Patients With Acute Pancreatitis Based on Etiology: An Analysis From the National Inpatient Sample, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.