The Impact of an Inpatient Pancreatitis Service and Educational Intervention Program on the Outcome of Acute Pancreatitis

Kandasamy, Cinthana; Shah, Ishani; Yakah, William; Ahmed, Awais; Tintara, Supisara; Sorrento, Cristina; Freedman, Steven D.; Kothari, Darshan; Sheth, Sunil G.

doi:10.1016/j.amjmed.2021.09.021

Cited by 5 publications

(12 citation statements)

References 22 publications

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“…While dedicated inpatient specialist consultation teams have been demonstrated in AP and other conditions to improve patient outcomes, studies show improvement is not necessarily equitable by race 15 . We hypothesize that an approach pairing a specialty consult team and also education of medical teams to adhere with standardized treatment guidelines may successfully improve care equitably among Black and White AP patients 7 …”

Section: Discussionmentioning

confidence: 91%

“…Our study found no difference in LOS, ICU admissions, significant local or extrapancreatic complications, readmission rates, or mortality between Black and White AP patients. One possible explanation for our findings is our hospital's unique protocol-driven AP treatment pathway that relies on objective measurements to guide treatment choices, such as fluid resuscitation, advancing diet, medication administration, and radiological imaging 7 . This pathway may leave less opportunity for implicit racial bias to influence providers' care.…”

Section: Discussionmentioning

confidence: 98%

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Racial Variations in Pain Management and Outcomes in Hospitalized Patients With Acute Pancreatitis

et al. 2022

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Objectives: Acute pancreatitis (AP) is a common cause of hospitalization. Black AP patients have higher risk for alcoholic etiology and hospitalization than White patients. We evaluated outcomes and treatment disparities by race in hospitalized AP patients. Methods:We retrospectively analyzed Black and White AP patients admitted 2008-2018. Primary outcomes were length of stay, intensive care unit admission, 30-day readmissions, and mortality. Secondary outcomes included pain scores, opioid dosing, and complications. Results:We identified 630 White and 186 Black AP patients. Alcoholic AP (P < 0.001), tobacco use (P = 0.013), and alcohol withdrawal (P < 0.001) were more common among Blacks. There were no differences in length of stay (P = 0.113), intensive care unit stay (P = 0.316), 30-day readmissions (P = 0.797), inpatient (P = 0.718) or 1-year (P = 0.071) mortality, complications (P = 0.080), or initial (P = 0.851) and discharge pain scores (P = 0.116). Discharge opioids were prescribed more frequently for Whites (P = 0.001).Conclusions: Hospitalized Black and White AP patients had similar treatment and outcomes. Standardized protocols used to manage care may eliminate racial biases. Disparities in discharge opioid prescriptions may be explained by higher alcohol and tobacco use by Black patients.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 98%

Racial Variations in Pain Management and Outcomes in Hospitalized Patients With Acute Pancreatitis

et al. 2022

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“…Our medical record offers 10-year follow-up in an unchanged electronic system allowing for accurate follow-up. In addition, the majority of our patients were followed by an inpatient pancreas service 22 …”

Section: Discussionmentioning

confidence: 99%

Evaluating the Clinical Characteristics and Outcomes of Idiopathic Acute Pancreatitis

et al. 2022

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ObjectiveUp to 30% of acute pancreatitis (AP) cases do not have an established etiology (idiopathic AP [IAP]). We evaluated the characteristics and outcomes of hospitalized IAP patients compared with those with established AP cause (non-IAP).MethodsA retrospective study of AP patients admitted to a single center from 2008 to 2018 was performed. Patients were divided into IAP and non-IAP groups. Outcomes included mortality, 30-day and 1-year readmission, length of stay (LOS), intensive care unit admissions, and complications.ResultsOf 878 AP patients, 338 had IAP and 540 non-IAP (234 gallstone, 178 alcohol). Groups had similar demographics, Charlson Comorbidity Index, and pancreatitis severity. The IAP patients had more 1-year readmissions (0.64 vs 0.55, P = 0.006) but similar 30-day readmissions and mortality. Patients with IAP had shorter LOS (4.98 vs 5.99 days, P = 0.01), and fewer intensive care unit admissions (3.25% vs 6.85%, P = 0.03) and extrapancreatic complications (15.4% vs 25.2%, P = 0.001). There was no difference in pain level between groups.ConclusionsThe IAP patients tend to have more readmissions in 1 year, but less severe presentations, shorter LOS, and fewer complications. Readmission rates may be related to lack of defined etiology and treatment to prevent recurrence.

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Section: Institution Bmentioning

confidence: 99%

“…Implementation of an inpatient pancreatitis service at Institution B, with an emphasis on guideline-based recommendations for acute pancreatitis, was associated with a decreased length of stay, refeeding time, and infections (9). The inpatient team also helped guide appropriate fluid resuscitation, reduced unnecessary imaging, and, if necessary, ensured communication with a surgeon, interventional radiologist, or advanced endoscopist. In addition, by working alongside a dedicated team dietician, the primary GI team has been able to ensure early enteral feeding, which may reduce time to resolution and improve outcomes by modulating the inflammatory response.…”

Section: Institution Bmentioning

confidence: 99%

Consultative vs Dedicated Inpatient Service for GI Training and Patient Care

et al. 2022

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The Impact of an Inpatient Pancreatitis Service and Educational Intervention Program on the Outcome of Acute Pancreatitis

Cited by 5 publications

References 22 publications

Racial Variations in Pain Management and Outcomes in Hospitalized Patients With Acute Pancreatitis

Racial Variations in Pain Management and Outcomes in Hospitalized Patients With Acute Pancreatitis

Evaluating the Clinical Characteristics and Outcomes of Idiopathic Acute Pancreatitis

Consultative vs Dedicated Inpatient Service for GI Training and Patient Care

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