Kalpit Devani1, Paris Charilaou2, Dhruvil Radadiya3, Bhaumik Brahmbhatt4, Mark Young5, Chakradhar Reddy5. 1. Division of Gastroenterology, Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA. Electronic address: kalpit_devani@yahoo.com. 2. Saint Peter's University Hospital/Rutgers, Robert Wood Johnson Medical School, New Brunswick, NJ, USA. 3. Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA. 4. Division of Gastroenterology, Mayo Clinic, Jacksonville, FL, USA. 5. Division of Gastroenterology, Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.
Abstract
OBJECTIVES: To assess national trends of AP (acute pancreatitis) admissions, outcomes, prevalence of AKI (acute kidney injury) in AP, and impact of AKI on inpatient mortality. METHODS: We queried the Nationwide Inpatient Sample database from 2003 to 2012 to identify AP admissions using ICD-9-CM codes. After excluding patients with missing information on age, gender, and inpatient mortality, we used ICD-9-CM codes to identify complications of AP, specifically AKI. We examined trends with survey-weighted multivariable regressions and analyzed predictors of AKI and inpatient mortality by multivariate logistic regression. Additionally, both AKI and non-AKI groups were propensity-matched and regressed against mortality. RESULTS: A total of 3,466,493 patients (1.13% of all discharges) were hospitalized with AP, of which 7.9% had AKI. AP admissions increased (1.02%→1.26%) with rise in concomitant AKI cases (4.1%→11.7%) from year 2003-2012. Mortality rate decreased (1.8%→1.1%) in the AP patients with a substantial decline noted in AKI subgroup (17.4%→6.4%) during study period. Length of stay (LOS) and cost of hospitalization decreased (6.1→5.2 days and $13,654 to $10,895, respectively) in AKI subgroup. Complications such as AKI (OR: 6.08, p < 0.001), septic shock (OR: 46.52, p < 0.001), and acute respiratory failure (OR: 22.72, p < 0.001) were associated with higher mortality. AKI, after propensity matching, was linked to 3-fold increased mortality (propensity-matched OR: 3.20, P < 0.001). CONCLUSION: Mortality, LOS, and cost of hospitalization in AP has decreased during the study period, although hospitalization and AKI prevalence has increased. AKI is independently associated with higher mortality.
OBJECTIVES: To assess national trends of AP (acute pancreatitis) admissions, outcomes, prevalence of AKI (acute kidney injury) in AP, and impact of AKI on inpatient mortality. METHODS: We queried the Nationwide Inpatient Sample database from 2003 to 2012 to identify AP admissions using ICD-9-CM codes. After excluding patients with missing information on age, gender, and inpatient mortality, we used ICD-9-CM codes to identify complications of AP, specifically AKI. We examined trends with survey-weighted multivariable regressions and analyzed predictors of AKI and inpatient mortality by multivariate logistic regression. Additionally, both AKI and non-AKI groups were propensity-matched and regressed against mortality. RESULTS: A total of 3,466,493 patients (1.13% of all discharges) were hospitalized with AP, of which 7.9% had AKI. AP admissions increased (1.02%→1.26%) with rise in concomitant AKI cases (4.1%→11.7%) from year 2003-2012. Mortality rate decreased (1.8%→1.1%) in the AP patients with a substantial decline noted in AKI subgroup (17.4%→6.4%) during study period. Length of stay (LOS) and cost of hospitalization decreased (6.1→5.2 days and $13,654 to $10,895, respectively) in AKI subgroup. Complications such as AKI (OR: 6.08, p < 0.001), septic shock (OR: 46.52, p < 0.001), and acute respiratory failure (OR: 22.72, p < 0.001) were associated with higher mortality. AKI, after propensity matching, was linked to 3-fold increased mortality (propensity-matched OR: 3.20, P < 0.001). CONCLUSION: Mortality, LOS, and cost of hospitalization in AP has decreased during the study period, although hospitalization and AKI prevalence has increased. AKI is independently associated with higher mortality.
Authors: Florian G Scurt; Ronnie Morgenroth; Katrin Bose; Peter R Mertens; Christos Chatzikyrkou Journal: Geburtshilfe Frauenheilkd Date: 2022-03-03 Impact factor: 2.915
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Authors: Jorge D Machicado; Amir Gougol; Xiaoqing Tan; Xiaotian Gao; Pedram Paragomi; Ioannis Pothoulakis; Rupjyoti Talukdar; Rakesh Kochhar; Mahesh K Goenka; Aiste Gulla; Jose A Gonzalez; Vikesh K Singh; Miguel Ferreira; Tyler Stevens; Sorin T Barbu; Haq Nawaz; Silvia C Gutierrez; Narcis O Zarnescu; Gabriele Capurso; Jeffrey J Easler; Konstantinos Triantafyllou; Mario Pelaez-Luna; Shyam Thakkar; Carlos Ocampo; Enrique de-Madaria; Gregory A Cote; Bechien U Wu; Darwin L Conwell; Phil A Hart; Gong Tang; Georgios I Papachristou Journal: United European Gastroenterol J Date: 2021-03 Impact factor: 4.623