Health Care Utilization and Costs Associated With Acute Pancreatitis

Wadhwa, Vaibhav; Patwardhan, Sujata; Garg, Sushil Kumar; Jobanputra, Yash; López, Rocío; Sanaka, Madhusudhan R.

doi:10.1097/mpa.0000000000000755

Cited by 52 publications

(41 citation statements)

References 24 publications

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“…This hospitalisation is associated with an estimated cost of $5,800 per patient 4,11 . Hospitalisation is necessary for 57% of the patients with thiopurine‐induced pancreatitis, with an estimate cost of $33,740 per hospitalisation per patient 35,36 . We estimate the costs of a genome‐wide genotyping array, designed to specifically tag pharmacogenetic predictors, to be approximately $50 per individual.…”

Section: Discussionmentioning

confidence: 99%

Predicted efficacy of a pharmacogenetic passport for inflammatory bowel disease

Bangma

Voskuil

Venema

et al. 2020

Aliment Pharmacol Ther

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This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. SummaryBackground: High inter-individual variability in therapeutic response to drugs used in the management of Inflammatory Bowel Disease (IBD) leads to high morbidity and high costs. Genetic variants predictive of thiopurine-induced myelosuppression, thiopurine-induced pancreatitis and immunogenicity of Tumour Necrosis Factor alpha (TNFα) antagonists have been identified, but uptake of pre-treatment pharmacogenetic testing into clinical guidelines has been slow. Aim:To explore the efficacy of a pharmacogenetic passport for IBD that includes multiple pharmacogenetic predictors of response. Methods:Patients with IBD exposed to thiopurines and/or TNFα antagonists were retrospectively evaluated for the presence of thiopurine toxicity and/or immunogenicity of TNFα antagonists. All patients were genotyped using both whole-exome sequencing and the Illumina Global Screening Array. An in-house-developed computational pipeline translated genetic data into an IBD pharmacogenetic passport that predicted risks for thiopurine toxicity and immunogenicity of TNFα antagonists per patient. Using pharmacogenetic-guided treatment guidelines, we calculated clinical efficacy estimates for pharmacogenetic testing for IBD.Results: Among 710 patients with IBD exposed to thiopurines and/or TNFα antagonists, 150 adverse drug responses occurred and our pharmacogenetic passport would have predicted 54 (36%) of these. Using a pharmacogenetic passport for IBD that includes genetic variants predictive of thiopurine-induced myelosuppression, thiopurine-induced pancreatitis, and immunogenicity of TNFα antagonists, 24 patients need to be genotyped to prevent one of these adverse drug responses. Conclusions:This study highlights the clinical efficacy of a pharmacogenetic passport for IBD. Implementation of such a pharmacogenetic passport into clinical management of IBD may contribute to a reduction in adverse drug responses. S U PP O RTI N G I N FO R M ATI O NAdditional supporting information will be found online in the Supporting Information section. How to cite this article: BangmaA, Voskuil MD, Uniken Venema WTC, et al. Predicted efficacy of a pharmacogenetic passport for inflammatory bowel disease. Aliment Pharmacol

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Section: Discussionmentioning

confidence: 99%

Predicted efficacy of a pharmacogenetic passport for inflammatory bowel disease

Bangma

Voskuil

Venema

et al. 2020

Aliment Pharmacol Ther

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“…Inconsistencies related to over-or under-coding are possible, but AHRQ quality control measures should minimize those possibilities. Also, the ICD-9 codes used in our study have been used and/or validated in several prior studies [28][29][30]. Second, we used the principle diagnosis of pancreatitis to identify our study cohort.…”

Section: Discussionmentioning

confidence: 99%

Temporal Trends and Predictors of Pancreatitis Patients Who Leave Against Medical Advice: A Nationwide Analysis

et al. 2020

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Background: Acute pancreatitis is the leading gastrointestinal cause of hospital admissions. Our study aims to determine the trends and predictors of discharge against medical advice (AMA). Methods: We utilized the Nationwide Inpatient Sample (2003-2016) to identify patients admitted with pancreatitis. We compared in-hospital complications and determined predictors of discharge AMA using a multivariate logistic regression. Results: A total of 7,158,894 patients were admitted with pancreatitis. Of those, 199,351 left AMA. Discharge AMA increased over time from 2.3% to 3.2%. Patients who left AMA were more likely to be younger, male, black, and a lower socioeconomic status (SES). They had a greater prevalence of depression, cirrhosis, smoking, drug abuse, and human immunodeficiency virus (HIV) infection. Alcohol use was the most likely etiology of pancreatitis among those leaving AMA. In a multivariate regression, patients more likely to leave AMA included: age 18-44, male, and black. Patients with a history of depression, drug abuse, and HIV infection were also more likely to be discharged AMA. Conclusions: Discharges AMA increased over time. Predictors of AMA include patients who are younger, male, black, lower socioeconomic status, and have a history of depression, HIV infection, alcohol and drug use. Future studies are necessary to examine the reasons for discharge AMA among this population.

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“…When CTSI scores were evaluated, it was seen that majority of our patients had mild AP (0-3 points, n = 18, 72%), followed by moderate (4-6 points, n = 6, 24%) and severe (7-10 points, n = 1, 4%). Average length of hospital stay was 6 days (range, [3][4][5][6][7][8][9][10][11][12][13][14] and there was no mortality.…”

Section: Assessment Of Disease Severity (Scoring)mentioning

confidence: 96%

“…However, the incidence seems to be similar [4]. It has also become the most common inpatient gastrointestinal diagnosis and costs an estimated 2.6 billion dollars per year in the USA [5], which is still increasing [6].…”

Section: Introductionmentioning

confidence: 99%