OBJECTIVES: This study aimed to compare severity of acute pancreatitis (AP) and mortality rates between transferred and nontransferred patients and to determine the factors that influence the decision to transfer. METHODS: A retrospective analysis coding a statewide administrative database in Maryland was conducted. Severity was defined by presence of organ failure (OF), need for intensive care unit (ICU), mechanical ventilation (MV), or hemodialysis. RESULTS: There were 71,035 discharges for AP, with 1657 (2.3%) patient transfers. Transferred patients had more multisystem OF (5.6% vs 1.2%), need for ICU (22.8% vs 4.3%), MV (13.1% vs 1.4%), hemodialysis (4.2% vs 2.7%), and higher mortality (6.1% vs 1.1%) compared with nontransferred patients (P < 0.0001). After adjusting for disease severity, mortality was similar between the transferred patients and the nontransferred patients (OR, 1.37; 95% confidence interval, 0.96-1.97). Younger (OR, 0.99), African American (OR, 0.55), and uninsured (OR, 0.46) patients were less likely to be transferred, whereas patients with multisystem OF (OR, 3.5), need for ICU (OR, 2.3), or MV (OR, 2.1) were more likely to be transferred (P < 0.0001). CONCLUSIONS: Transferred patients with AP have more severe disease and higher overall mortality. Mortality is similar after adjusting for disease severity. Disease severity, insurance status, race, and age all influence the decision to transfer patients with AP.
OBJECTIVES: This study aimed to compare severity of acute pancreatitis (AP) and mortality rates between transferred and nontransferred patients and to determine the factors that influence the decision to transfer. METHODS: A retrospective analysis coding a statewide administrative database in Maryland was conducted. Severity was defined by presence of organ failure (OF), need for intensive care unit (ICU), mechanical ventilation (MV), or hemodialysis. RESULTS: There were 71,035 discharges for AP, with 1657 (2.3%) patient transfers. Transferred patients had more multisystem OF (5.6% vs 1.2%), need for ICU (22.8% vs 4.3%), MV (13.1% vs 1.4%), hemodialysis (4.2% vs 2.7%), and higher mortality (6.1% vs 1.1%) compared with nontransferred patients (P < 0.0001). After adjusting for disease severity, mortality was similar between the transferred patients and the nontransferred patients (OR, 1.37; 95% confidence interval, 0.96-1.97). Younger (OR, 0.99), African American (OR, 0.55), and uninsured (OR, 0.46) patients were less likely to be transferred, whereas patients with multisystem OF (OR, 3.5), need for ICU (OR, 2.3), or MV (OR, 2.1) were more likely to be transferred (P < 0.0001). CONCLUSIONS: Transferred patients with AP have more severe disease and higher overall mortality. Mortality is similar after adjusting for disease severity. Disease severity, insurance status, race, and age all influence the decision to transfer patients with AP.
Authors: David X Jin; Julia Y McNabb-Baltar; Shadeah L Suleiman; Bechien U Wu; Ramin Khorasani; Thomas L Bollen; Peter A Banks; Vikesh K Singh Journal: Dig Dis Sci Date: 2017-08-24 Impact factor: 3.199
Authors: Cemal Yazici; Kyle Geary; Angelica Sanchez; Brian R Boulay; Georgios I Papachristou; Nancy Krett; Paul J Grippo; Barbara Jung Journal: Pancreas Date: 2019-10 Impact factor: 3.327
Authors: Rupjyoti Talukdar; Ayesha Kamal; Venkata S Akshintala; Rajesh Goud; Sundeep Lakhtakia; Mohan K Ramchandani; Manu Tandan; G V Rao; Zaheer Nabi; Rajesh Gupta; Rakesh Kalapala; Jahangeer Basha; Manohar Reddy; Vijay K Rai; Mahesh K Goenka; Saroj Sinha; Rakesh Kochhar; B Joseph Elmunzer; Mouen A Khashab; Anthony N Kalloo; Vikesh K Singh; D Nageshwar Reddy Journal: Endosc Int Open Date: 2020-06-16