Alecia M Blaszczak1, Somashekar G Krishna2, Phil A Hart2, David Bradley1, Willa Hsueh1, Luis F Lara2, Hisham Hussan2, Alice Hinton3, Darwin L Conwell2, Zobeida Cruz-Monserrate4. 1. Diabetes and Metabolism Research Center, Division of Endocrinology, Diabetes & Metabolism, Department of Internal Medicine, The Ohio State University, Wexner Medical Center, Columbus, OH, 43210, USA. 2. Division of Gastroenterology, Hepatology, and Nutrition, Division of Internal Medicine, The Ohio State University, Wexner Medical Center, Columbus, OH, 43210, USA; The Comprehensive Cancer Center, Arthur G. James Cancer Hospital, Richard J. Solove Research Institute, The Ohio State University, Columbus, OH, 43210, USA. 3. Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA. 4. Division of Gastroenterology, Hepatology, and Nutrition, Division of Internal Medicine, The Ohio State University, Wexner Medical Center, Columbus, OH, 43210, USA; The Comprehensive Cancer Center, Arthur G. James Cancer Hospital, Richard J. Solove Research Institute, The Ohio State University, Columbus, OH, 43210, USA. Electronic address: zobeida.cruz-monserrate@osumc.edu.
Abstract
OBJECTIVES: The incidence rates of acute pancreatitis (AP) and the prevalence of class III obesity, and metabolic syndrome (MetS) are increasing in the US. Since class III obesity was associated with adverse clinical outcomes of AP, we sought to understand if the presence of metabolic comorbidities collectively recognized, as MetS were associated with worse clinical outcomes and increased health-care utilization. METHODS: The Nationwide Readmissions Database (NRD) (2010-2014) was reviewed to identify all adult subjects with a principal discharge diagnosis of AP. Inpatient mortality, severe AP (SAP), and 30-day readmissions were the primary outcomes analyzed. Propensity score weighted analyses were used to compare AP subjects with and without MetS and were further stratified by class III obesity status. RESULTS: MetS was associated with 12.91% (139,165/1,078,183) of all admissions with AP. Propensity score weighted analyses showed that MetS was associated with an increased proportion of SAP (OR 1.21, 95% CI 1.17, 1.25), but decreased mortality (OR 0.62, 95% CI 0.54, 0.70) and 30-day readmissions (OR 0.86, 95% CI 0.83, 0.89). Propensity score weighted analyses also revealed that class III obesity was independently associated with increased mortality in AP subjects with (OR 1.92, 95% CI 1.41, 2.61) and without MetS (OR 1.55, 95% CI 1.26, 1.92), and increased SAP in subjects with and without MetS. CONCLUSIONS: Class III obesity appears to be the primary factor associated with adverse clinical outcomes in subjects with MetS admitted with AP. This has significant implications for patient management and future research targeting AP.
OBJECTIVES: The incidence rates of acute pancreatitis (AP) and the prevalence of class III obesity, and metabolic syndrome (MetS) are increasing in the US. Since class III obesity was associated with adverse clinical outcomes of AP, we sought to understand if the presence of metabolic comorbidities collectively recognized, as MetS were associated with worse clinical outcomes and increased health-care utilization. METHODS: The Nationwide Readmissions Database (NRD) (2010-2014) was reviewed to identify all adult subjects with a principal discharge diagnosis of AP. Inpatient mortality, severe AP (SAP), and 30-day readmissions were the primary outcomes analyzed. Propensity score weighted analyses were used to compare AP subjects with and without MetS and were further stratified by class III obesity status. RESULTS: MetS was associated with 12.91% (139,165/1,078,183) of all admissions with AP. Propensity score weighted analyses showed that MetS was associated with an increased proportion of SAP (OR 1.21, 95% CI 1.17, 1.25), but decreased mortality (OR 0.62, 95% CI 0.54, 0.70) and 30-day readmissions (OR 0.86, 95% CI 0.83, 0.89). Propensity score weighted analyses also revealed that class III obesity was independently associated with increased mortality in AP subjects with (OR 1.92, 95% CI 1.41, 2.61) and without MetS (OR 1.55, 95% CI 1.26, 1.92), and increased SAP in subjects with and without MetS. CONCLUSIONS: Class III obesity appears to be the primary factor associated with adverse clinical outcomes in subjects with MetS admitted with AP. This has significant implications for patient management and future research targeting AP.
Authors: Somashekar G Krishna; Jennifer Behzadi; Alice Hinton; Samer El-Dika; Jeffery R Groce; Hisham Hussan; Phil A Hart; Darwin L Conwell Journal: Clin Gastroenterol Hepatol Date: 2016-02-22 Impact factor: 11.382
Authors: Bettina Woelnerhanssen; Ralph Peterli; Robert E Steinert; Thomas Peters; Yves Borbély; Christoph Beglinger Journal: Surg Obes Relat Dis Date: 2011-03-22 Impact factor: 4.734
Authors: M Zeyda; D Farmer; J Todoric; O Aszmann; M Speiser; G Györi; G J Zlabinger; T M Stulnig Journal: Int J Obes (Lond) Date: 2007-06-26 Impact factor: 5.095
Authors: Peter A Banks; Thomas L Bollen; Christos Dervenis; Hein G Gooszen; Colin D Johnson; Michael G Sarr; Gregory G Tsiotos; Santhi Swaroop Vege Journal: Gut Date: 2012-10-25 Impact factor: 23.059
Authors: Naveed Sattar; Alex McConnachie; A Gerald Shaper; Gerard J Blauw; Brendan M Buckley; Anton J de Craen; Ian Ford; Nita G Forouhi; Dilys J Freeman; J Wouter Jukema; Lucy Lennon; Peter W Macfarlane; Michael B Murphy; Chris J Packard; David J Stott; Rudi G Westendorp; Peter H Whincup; James Shepherd; S Goya Wannamethee Journal: Lancet Date: 2008-05-22 Impact factor: 79.321