Predictors for early readmission in acute pancreatitis (AP) in the United States (US) – A nationwide population based study

Munigala, Satish; Subramaniam, Divya S.; Subramaniam, Dipti P.; Buchanan, Paula; Xian, Hong; Burroughs, Thomas E.; Trikudanathan, Guru

doi:10.1016/j.pan.2017.05.391

Cited by 37 publications

(35 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Gallstones remained the most common cause of disease in two thirds of the cases, and the majority of patients did not have cholecystectomy. As it is known that cholecystectomy reduces the recurrence rate of gallstones, we believe that may partially explain our results. All of the patients who underwent LC had an uneventful postoperative course.…”

Section: Discussionmentioning

confidence: 52%

Outcome of acute pancreatitis in octogenarians: A retrospective study

et al. 2019

View full text Add to dashboard Cite

Background and Aim Acute pancreatitis (AP) is a common disease, but data on outcomes in octogenarians are scarce in the literature. The aim of this study is to analyze results from patients aged 80 years old and over who were treated for AP at a single center. Methods Patients aged 80 years and older diagnosed with AP from April 2010 to October 2015 were considered. Demographics, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), serum biochemistry at 24 and 48 h after admission, and revised Atlanta severity score were analyzed and correlated with hospital mortality rate and length of stay using the multiple regression and Kaplan–Meier tests. Results A total of 100 consecutive patients were included in the study. There were 52 women, and the mean age was 87.5 years (range 80–95). Gallstones were the most common cause of AP (69.7%). The ASA score was ≥III in 51 patients. Eight patients had severe, disease and all of them died in hospital. A CCI > 4 was associated with higher disease severity and mortality (P < 0.00001). The median hospital stay was 9 days (range 1–59). Longer hospital stay was associated with serum C‐reactive protein ≥242 mg/L (P = 0.01) and serum albumin ≤30 g/L (P = 0.01) at 48 h. Over a 5‐year period, 22% of patients were readmitted to hospital with recurrent AP. Gallstones were the main cause of disease (63.6%). Conclusions AP in octogenarians has low mortality. Higher death rate is associated with disease severity. In the presence of gallstone disease, cholecystectomy is recommended whenever possible as the risk of disease recurrence is significant.

show abstract

Section: Discussionmentioning

confidence: 52%

Outcome of acute pancreatitis in octogenarians: A retrospective study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…A jelen kutatás során a klinikánkon akut pancreatitis diagnózisával kezelt betegek körében vizsgáltuk a korai, nem tervezett visszavételi arányt. Bár a korai visszavételi ráta a kórházi ellátás minőségi mutatója, csupán pár publikáció jelent meg ebben a témában [5,7,8,10,11,14].…”

Section: Megbeszélésunclassified

“…Ezekben az akut pancreatitis első kezelését követő visszavétel aránya 15-29% között változik [5][6][7][8][9][10][11]. A visszavétel leggyakoribb okai között az akut pancreatitis visszatérése; fellángoló panaszok, úgymint hányinger, hányás és hasi fájdalom [6]; az akut pancreatitis késői lokális szövődményei (pseudocysta, demarkált pancreasnecrosis és epeúti abnormalitások) szerepelnek [11]. A jelen kutatás során célunk az akut pancreatitis diagnózisa miatt klinikánkon primeren kezelt betegek 30 napos, nem tervezett visszavételi arányának, a visszavétel okának és kimenetelének vizsgálata volt.…”

unclassified

Az akut pancreatitist követő kórházi visszavételi arány mint minőségi mutató

Illés

Czakó

2021

View full text Add to dashboard Cite

Összefoglaló. Bevezetés: Az akut pancreatitis az egyik leggyakoribb kórházi felvételt igénylő gastrointestinalis kórkép. A korai visszavételi arány egyrészt az ellátást jellemző minőségi mutató, másrészt az akut pancreatitis 1 éves mortalitásának legerősebb prognosztikai faktora. Célkitűzés: A korai visszavétel arányának, illetve okainak vizsgálata klinikánkon akut pancreatitis diagnózisával kezelt betegek körében. Módszerek: Retrospektív vizsgálatunkat azon 18 év feletti betegek körében végeztük, akiket a 2010. január és 2018. december közötti időszakban akut pancreatitis diagnózisával kezeltünk klinikánkon, és az első emissziótól számítva 30 napon belül újból felvételre kerültek. A betegek adatait az Akut Pancreatitis Regiszter és a betegnyilvántartó rendszer (MedSol ) segítségével gyűjtöttük össze. A biliaris, illetve nem biliaris akut pancreatitises eseteket hasonlítottuk össze az epidemiológiai adatok, a visszavétel oka, a visszavételig eltelt átlagos időtartam, és a visszavétel időtartama, valamint kimenetele vonatkozásában. Eredmények: Akut pancreatitis diagnózisával 647 beteg került felvételre. Közülük 28 beteg került újrafelvételre. A leggyakoribb okok között 1) peripancreaticus szövődmények, 2) epés panaszok és 3) az akut pancreatitis kiújulása szerepel. A biliaris és a nem biliaris pancreatitises eseteket összehasonlítva, a visszavétel oka epés panasz volt az előbbi csoport 65,5%-ában és az utóbbi 15%-ában. A középsúlyos pancreatitises esetek száma szignifikánsan magasabbnak adódott a nem biliaris csoportban. Következtetés: A középsúlyos/súlyos pancreatitises esetek aránya magasabb volt a nem biliaris pancreatitises csoportban. Biliaris pancreatitis esetén javasolt index-cholecystectomia végzése. Orv Hetil. 2021; 162(11): 413–418. Summary. Introduction: Acute pancreatitis is the leading cause of hospitalization among gastrointestinal diseases. The early readmission rate is a quality marker and the strongest prognostical factor of 1-year mortality of acute pancreatitis. Objective: To investigate the rate and cause of early readmission among patients treated with acute pancreatitis at our clinic. Methods: Our retrospective study was conducted among patients (>18 years) treated with acute pancreatitis between January 2010 and December 2018 at our clinic, by whom unplanned readmission happened <30 days from emission. Personal data were collected from the Hungarian Pancreas Registry. Data of biliary and non-biliary acute pancreatitis cases were compared concerning epidemiological data, cause of readmission, mean time elapsed until readmission, its duration and outcome. Results: 647 patients were diagnosed with acute pancreatitis. Of them, 28 patients had early readmission. The most common causes were 1) local pancreatic complications, 2) biliary and 3) recurrence of acute pancreatitis. By investigating the biliary and non-biliary pancreatitis cases separately, the cause of readmission was biliary in 65.5% and 15%, respectively. The number of moderately severe pancreatitis cases was significantly higher in the non-biliary group. Conclusion: The proportion of moderate/severe diseases was higher in the non-biliary pancreatitis group. In the case of biliary pancreatitis, it is suggested to perform index cholecystectomy. Orv Hetil. 2021; 162(11): 413–418.

show abstract

“…However, the cases that originated from alcohol and idiopathic etiology remained at high risk for early readmission. 17 Whitlock et al (2011) have developed a scoring system to determine a risk for early readmission in AP, which includes symptoms at discharge, presence of pancreatic necrosis, and the ability to tolerate diet. 18 Our study showed an association of early aggressive hydration with reduced 30-days readmission.…”

Section: -Day Readmissionmentioning

confidence: 99%

Early Aggressive Hydration Is Associated with Decreased Opioid Use and Readmission in Mild Acute Pancreatitis

Doshi¹,

Liang²,

Toklu³

et al. 2020

HCA Healthcare Journal of Medicine

View full text Add to dashboard Cite

Background Acute pancreatitis (AP) is one of the most common causes of hospital admissions due to gastrointestinal disorders. No pharmacologic agents have been proven to impact the prognosis, and the treatment still remains supportive with intravenous fluids for hydration. Although early hydration has been recommended for the management of mild AP, there is no consensus on the type, rate, and amount of the fluid replacement. Objective In this study, we aimed to investigate the outcome of aggressive hydration in patients with AP. Methods Retrospective data from patients admitted to 12 hospitals (2015-2017) was used for analysis. Five hundred patients who met the inclusion and exclusion criteria for mild AP were included. The subjects were classified into 3 groups based on the amount of intravenous fluids they received in the first 12 hours of admission: Hydration group A (0-1.5 ml/kg/h), Hydration group B (>1.5-3 ml/kg/h) and Hydration group C (>3 ml/kg/h). Laboratory test results on the second day of admission, length of stay (LOS) and opioid analgesic use on the last day were analyzed using a Chi-square test. A p-value of less than 0.05 was considered statistically significant. Results Patients with aggressive hydration (>3 ml/kg/h) had a greater reduction in creatinine (mean difference =-0.05, p = 0.017) compared to those who received standard hydration (0-1.5 ml/kg/h). There was no significant difference in LOS among the three hydration groups. Patients with aggressive hydration were less likely to use opioid analgesics on the last day of hospitalization (23.9% vs. 35.3%, p = 0.044) compared to standard hydration. Patients with hydration were less likely to experience a readmission for any reason within 30 days (Odds ratio (OR) = 1.603, 95% CI, 1.064-2.414, p = 0.024) compared to those who received low hydration. Conclusions Our findings showed that less narcotics were required for the patients receiving aggressive hydration in mild AP. On the other hand, early aggressive hydration is not widely implemented in community hospitals, despite beneficial effects.

show abstract

Predictors for early readmission in acute pancreatitis (AP) in the United States (US) – A nationwide population based study

Cited by 37 publications

References 29 publications

Outcome of acute pancreatitis in octogenarians: A retrospective study

Outcome of acute pancreatitis in octogenarians: A retrospective study

Az akut pancreatitist követő kórházi visszavételi arány mint minőségi mutató

Early Aggressive Hydration Is Associated with Decreased Opioid Use and Readmission in Mild Acute Pancreatitis

Contact Info

Product

Resources

About