Rushikesh Shah1, Christopher Haydek2, Ramzi Mulki1, Emad Qayed3. 1. Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, 49 Jesse Hill Junior Drive, Atlanta, GA 30303, United States. 2. Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States. 3. Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, 49 Jesse Hill Junior Drive, Atlanta, GA 30303, United States. Electronic address: eqayed@emory.edu.
Abstract
BACKGROUND: Patients with chronic pancreatitis are prone to frequent readmissions. The aim of this study is to evaluate the rate and predictors of 30-day readmissions in patients with chronic pancreatitis using the Nationwide Readmission Database (NRD). METHODS: We performed a retrospective analysis of all adult patients with the principal discharge diagnosis of chronic pancreatitis from 2010 through 2014. We excluded patients who died during the hospitalization. Multivariate Cox proportional hazard regression was performed to identify demographic, clinical, and hospital factors that associated with 30-day unplanned readmissions. RESULTS: During the study period, 25,259 patients had the principal discharge diagnosis of chronic pancreatitis and survived the index hospitalization. Of these, 6477 (26.7%) were readmitted within 30 days. Younger age group, males, length of stay >5 days, admission to a large, metropolitan hospital, and several comorbidities (renal failure, rheumatic disease, chronic anemia, heart failure, depression, drug abuse, psychosis, and diabetes) were independently associated with increased risk of 30-day readmission. ERCP, pancreatic surgery, and obesity were associated with lower risk. The most common reasons for readmissions were acute pancreatitis (30%), chronic pancreatitis (17%), pseudocyst (2%), and abdominal pain (6%). CONCLUSIONS: One in four patients with chronic pancreatitis is readmitted within 30 days (26.7%). Pancreatic disease accounts for at least half of all readmissions. Several baseline comorbidities and characteristics are associated with 30-day readmission risk after index admission. Knowledge of these predictors can help design interventions to target high-risk patients and reduce readmissions and costs of care.
BACKGROUND:Patients with chronic pancreatitis are prone to frequent readmissions. The aim of this study is to evaluate the rate and predictors of 30-day readmissions in patients with chronic pancreatitis using the Nationwide Readmission Database (NRD). METHODS: We performed a retrospective analysis of all adult patients with the principal discharge diagnosis of chronic pancreatitis from 2010 through 2014. We excluded patients who died during the hospitalization. Multivariate Cox proportional hazard regression was performed to identify demographic, clinical, and hospital factors that associated with 30-day unplanned readmissions. RESULTS: During the study period, 25,259 patients had the principal discharge diagnosis of chronic pancreatitis and survived the index hospitalization. Of these, 6477 (26.7%) were readmitted within 30 days. Younger age group, males, length of stay >5 days, admission to a large, metropolitan hospital, and several comorbidities (renal failure, rheumatic disease, chronic anemia, heart failure, depression, drug abuse, psychosis, and diabetes) were independently associated with increased risk of 30-day readmission. ERCP, pancreatic surgery, and obesity were associated with lower risk. The most common reasons for readmissions were acute pancreatitis (30%), chronic pancreatitis (17%), pseudocyst (2%), and abdominal pain (6%). CONCLUSIONS: One in four patients with chronic pancreatitis is readmitted within 30 days (26.7%). Pancreatic disease accounts for at least half of all readmissions. Several baseline comorbidities and characteristics are associated with 30-day readmission risk after index admission. Knowledge of these predictors can help design interventions to target high-risk patients and reduce readmissions and costs of care.
Authors: Pedro Palacios Argueta; Miguel Salazar; Ishaan Vohra; Juan E Corral; Frank J Lukens; John J Vargo; Prabhleen Chahal; C Roberto Simons-Linares Journal: Dig Dis Sci Date: 2021-01-19 Impact factor: 3.199
Authors: Ellyn Dunbar; Phil J Greer; Nadine Melhem; Samer Alkaade; Stephen T Amann; Randall Brand; Gregory A Coté; Christopher E Forsmark; Timothy B Gardner; Andres Gelrud; Nalini M Guda; Jessica LaRusch; Michele D Lewis; Jorge D Machicado; Thiruvengadam Muniraj; Georgios I Papachristou; Joseph Romagnuolo; Bimaljit S Sandhu; Stuart Sherman; Charles M Wilcox; Vikesh K Singh; Dhiraj Yadav; David C Whitcomb Journal: J Gastroenterol Date: 2020-07-17 Impact factor: 6.772