Incidence, Burden, and Predictors of Readmission for Acute Alcoholic Pancreatitis: A National Analysis over 11 Months

Nieto, Luis M.; Salazar, Miguel; Kinnucan, Jami; Lukens, Frank; Argueta, Pedro Palacios

doi:10.1007/s10620-022-07798-w

Cited by 8 publications

(5 citation statements)

References 36 publications

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“…RNA was isolated from flash frozen pancreas tissues using the RNeasy Kit (Qiagen) according to the manufacturer’s protocol. cDNA generated after performing reverse transcription of RNA product was subjected to quantitative PCR (qPCR) analysis using gene-specific predesigned primers (RT 2 qPCR Primer Assay, Qiagen), listed in Supplementary Table S4. Gene expression was normalized to the housekeeping gene GAPDH using the comparative CT ( ΔΔ CT) method and reported as fold change relative to control.…”

Section: Methodsmentioning

confidence: 99%

“…Alcoholic pancreatitis, whether acute or chronic, is a severe disease that negatively impacts the exocrine pancreas and acknowledged as of one the most significant risk factors for pancreatic cancer 1, 2 . Notably, alcohol abuse is a prominent etiological factor responsible for chronic pancreatitis (CP), accounting for 60-90% of cases, which typically arises from recurrent episodes of acute pancreatitis 3, 4 .…”

Section: Introductionmentioning

confidence: 99%

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CREB activation drives acinar to ductal reprogramming and promote pancreatic cancer progression in animal models of alcoholic chronic pancreatitis

Srinivasan,

Mehra,

Bianchi

et al. 2024

Preprint

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BACKGROUND AND AIMSIn vivoinduction of alcoholic chronic pancreatitis (ACP) causes significant acinar damage, increased fibroinflammatory response, and heightened activation of cyclic response element binding protein 1 (CREB) when compared with alcohol (A) or chronic pancreatitis (CP) mediated pancreatic damage. However, the study elucidating the cooperative interaction between CREB and the oncogenicKrasG12D/+(Kras*) in promoting pancreatic cancer progression with ACP remains unexplored.METHODSExperimental ACP induction was established in multiple mouse models, followed by euthanization of the animals at various time intervals during the recovery periods. Tumor latency was determined in these mice cohorts. Here, we established CREB deletion (Crebfl/fl) inPtf1aCreERTM/+;LSL-KrasG12D+/−(KC) genetic mouse models (KCC−/−). Western blot, phosphokinase array, and qPCR were used to analyze the pancreata ofPtf1aCreERTM+/−,KCandKCC−/−mice. The pancreata of ACP-inducedKCmice were subjected to single-cell RNA sequencing (scRNAseq). Further studies involved conducting lineage tracing and acinar cell explant cultures.RESULTSACP induction inKCmice had detrimental effects on the pancreatic damage repair mechanism. The persistent existence of acinar cell-derived ductal lesions demonstrated a prolonged state of hyperactivated CREB. Persistent CREB activation leads to acinar cell reprogramming and increased pro-fibrotic inflammation inKCmice. Acinar-specificCrebablation reduced advanced PanINs lesions, hindered tumor progression, and restored acinar cell function in ACP-induced mouse models.CONCLUSIONSOur findings demonstrate that CREB cooperates withKras*to perpetuate an irreversible ADM and PanIN formation. Moreover, CREB sustains oncogenic activity to promote the progression of premalignant lesions toward cancer in the presence of ACP.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CREB activation drives acinar to ductal reprogramming and promote pancreatic cancer progression in animal models of alcoholic chronic pancreatitis

Srinivasan,

Mehra,

Bianchi

et al. 2024

Preprint

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“…However, it does not track patients across different states or over the transition to a new year. In line with previous research, individuals who had been discharged in December were not included in our analysis because their readmissions might have occurred in January of the subsequent year[ 24 ]. This retrospective cohort study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines[ 25 ].…”

Section: Methodsmentioning

confidence: 99%

Association between acute peripancreatic fluid collections and early readmission in acute pancreatitis: A propensity-matched analysis

Ali,

Inayat,

Rasheed

et al. 2024

World J Exp Med

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BACKGROUND Patients with acute pancreatitis (AP) frequently experience hospital readmissions, posing a significant burden to healthcare systems. Acute peripancreatic fluid collection (APFC) may negatively impact the clinical course of AP. It could worsen symptoms and potentially lead to additional complications. However, clinical evidence regarding the specific association between APFC and early readmission in AP remains scarce. Understanding the link between APFC and readmission may help improve clinical care for AP patients and reduce healthcare costs. AIM To evaluate the association between APFC and 30-day readmission in patients with AP. METHODS This retrospective cohort study is based on the Nationwide Readmission Database for 2016-2019. Patients with a primary diagnosis of AP were identified. Participants were categorized into those with and without APFC. A 1:1 propensity score matching for age, gender, and Elixhauser comorbidities was performed. The primary outcome was early readmission rates. Secondary outcomes included the incidence of inpatient complications and healthcare utilization. Unadjusted analyses used Mann-Whitney U and χ 2 tests, while Cox regression models assessed 30-day readmission risks and reported them as adjusted hazard ratios (aHR). Kaplan-Meier curves and log-rank tests verified readmission risks. RESULTS A total of 673059 patients with the principal diagnosis of AP were included. Of these, 5.09% had APFC on initial admission. After propensity score matching, each cohort consisted of 33914 patients. Those with APFC showed a higher incidence of inpatient complications, including septic shock (3.1% vs 1.3%, P < 0.001), portal venous thrombosis (4.4% vs 0.8%, P < 0.001), and mechanical ventilation (1.8% vs 0.9%, P < 0.001). The length of stay (LOS) was longer for APFC patients [4 (3-7) vs 3 (2-5) days, P < 0.001], as were hospital charges ($29451 vs $24418, P < 0.001). For 30-day readmissions, APFC patients had a higher rate (15.7% vs 6.5%, P < 0.001) and a longer median readmission LOS (4 vs 3 days, P < 0.001). The APFC group also had higher readmission charges ($28282 vs $22865, P < 0.001). The presence of APFC increased the risk of readmission twofold (aHR 2.52, 95% confidence interval: 2.40-2.65, P < 0.001). The independent risk factors for 30-day readmission included female gender, Elixhauser Comorbidity Index ≥ 3, chronic pulmonary diseases, chronic renal disease, protein-calorie malnutrition, substance use disorder, depression, portal and splenic venous thrombosis, and certain endoscopic procedures. CONCLUSION Developing APFC during index hospitalization for AP is linked to higher readmission rates, more inpatient complications, longer LOS, and increased healthcare costs. Knowing predictors of readmission can help target high-risk patients, reducing healthcare burdens.

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“…In-hospital mortality in AAP depends on the type of study selected, but varies between 1.1% [ 4 ] and 8.4% [ 5 ]. The highest mortality rate related to AAP has been reported in Russia (2.7/100,000 people) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Alcoholic Acute Pancreatitis, a Retrospective Study about Clinical Risk Factors and Outcomes—A Seven-Year Experience of a Large Tertiary Center

Gűnșahin,

Edu,

Pahomeanu

et al. 2024

Biomedicines

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(1) Background: Alcohol consumption is one of the main causes of acute pancreatitis. (2) Material and Methods: In this unicentric retrospective cohort study, we selected 1855 patients from the Bucharest Acute Pancreatitis Index (BUC-API) who presented with acute pancreatitis. We investigated correlations between Alcoholic Acute Pancreatitis (AAP) and the rate of complications, cost, length of hospitalization and rate of recurrence. (3) Results: We found a moderately strong association between AAP and recurrence (p < 0.01) and observed that the disease is likelier to evolve with pseudocysts and walled-off necrosis than other forms of AP. Patients with AAP are less likely to have a morphologically normal pancreas than patients suffering from AP of other causes (p < 0.01), but a low probability of requiring intensive care unit admission (p < 0.01) significantly lowers daily cost (Md = 154.7 EUR compared to Md = 204.4 EUR) (p < 0.01). (4) Conclusions: This study’s data show that patients with AAP have a greater rate of pseudocyst occurrence, lower intensive care unit admittance rate and lower cost of hospitalization than patients with AP of other causes. Typical Sketch: A middle-aged male tobacco smoker with recurrent AP, lower risk of in-hospital mortality and complications such as pseudocysts; treated in a gastroenterological ward and discharged at-will.

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Incidence, Burden, and Predictors of Readmission for Acute Alcoholic Pancreatitis: A National Analysis over 11 Months

Cited by 8 publications

References 36 publications

CREB activation drives acinar to ductal reprogramming and promote pancreatic cancer progression in animal models of alcoholic chronic pancreatitis

CREB activation drives acinar to ductal reprogramming and promote pancreatic cancer progression in animal models of alcoholic chronic pancreatitis

Association between acute peripancreatic fluid collections and early readmission in acute pancreatitis: A propensity-matched analysis

Alcoholic Acute Pancreatitis, a Retrospective Study about Clinical Risk Factors and Outcomes—A Seven-Year Experience of a Large Tertiary Center

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