Pedro Palacios Argueta1, Miguel Salazar2, Ishaan Vohra1, Juan E Corral3, Frank J Lukens3, John J Vargo2, Prabhleen Chahal2, C Roberto Simons-Linares4. 1. Internal Medicine Department, John Stroger Hospital of Cook County, Rush University, Chicago, IL, USA. 2. Gastroenterology, Hepatology and Nutrition Department, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. 3. Gastroenterology and Hepatology Department, Mayo Clinic Florida, Jacksonville, FL, USA. 4. Gastroenterology, Hepatology and Nutrition Department, Digestive Diseases and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. simonsc@ccf.org.
Abstract
BACKGROUND/ OBJECTIVES: Alcoholic acute pancreatitis (AAP) comprises the second most common cause of acute pancreatitis in the USA, and there is lack of data regarding 30-day specific readmission causes and predictors. We aim to identify 30-day readmission rate, causes, and predictors of readmission. METHODS: Retrospective analysis of the 2016 National Readmission Database of adult patients readmitted within 30 days after an index admission for AAP. RESULTS: Totally, 76,609 AAP patients were discharged from the hospital in 2016. The 30-day readmission rate was 12%. The main cause of readmission was another episode of AAP. Readmission was not associated with higher mortality (1.3% vs. 1.2%; P = 0.21) or prolonged length of stay (5.2 vs. 5.0 days; P = 0.06). The total health care economic burden was $354 million in charges and $90 million in costs. Independent predictors of readmission were having Medicaid insurance, a Charlson comorbidity index score ≥ 3, use of total parenteral nutrition, opioid abuse disorder, prior pancreatic cyst, chronic alcoholic pancreatitis, and other chronic pancreatitis. Obesity was associated with lower odds of readmission. CONCLUSION: Readmission rate for AAP is high and its primary cause are recurrent episodes of AAP. Alcohol and substance abuse pose a high burden on our health care system. Public health strategies should be targeted to provide alcohol abuse disorder rehabilitation and cessation resources to alleviate the burden on readmission, the health care system and to improve patient outcomes.
BACKGROUND/ OBJECTIVES: Alcoholic acute pancreatitis (AAP) comprises the second most common cause of acute pancreatitis in the USA, and there is lack of data regarding 30-day specific readmission causes and predictors. We aim to identify 30-day readmission rate, causes, and predictors of readmission. METHODS: Retrospective analysis of the 2016 National Readmission Database of adult patients readmitted within 30 days after an index admission for AAP. RESULTS: Totally, 76,609 AAP patients were discharged from the hospital in 2016. The 30-day readmission rate was 12%. The main cause of readmission was another episode of AAP. Readmission was not associated with higher mortality (1.3% vs. 1.2%; P = 0.21) or prolonged length of stay (5.2 vs. 5.0 days; P = 0.06). The total health care economic burden was $354 million in charges and $90 million in costs. Independent predictors of readmission were having Medicaid insurance, a Charlson comorbidity index score ≥ 3, use of total parenteral nutrition, opioid abuse disorder, prior pancreatic cyst, chronic alcoholic pancreatitis, and other chronic pancreatitis. Obesity was associated with lower odds of readmission. CONCLUSION: Readmission rate for AAP is high and its primary cause are recurrent episodes of AAP. Alcohol and substance abuse pose a high burden on our health care system. Public health strategies should be targeted to provide alcohol abuse disorder rehabilitation and cessation resources to alleviate the burden on readmission, the health care system and to improve patient outcomes.
Authors: Tom L Whitlock; Kathryn Repas; April Tignor; Darwin Conwell; Vikesh Singh; Peter A Banks; Bechien U Wu Journal: Am J Gastroenterol Date: 2010-06-08 Impact factor: 10.864
Authors: Anne F Peery; Seth D Crockett; Caitlin C Murphy; Jennifer L Lund; Evan S Dellon; J Lucas Williams; Elizabeth T Jensen; Nicholas J Shaheen; Alfred S Barritt; Sarah R Lieber; Bharati Kochar; Edward L Barnes; Y Claire Fan; Virginia Pate; Joseph Galanko; Todd H Baron; Robert S Sandler Journal: Gastroenterology Date: 2018-10-10 Impact factor: 22.682
Authors: Tom L Whitlock; April Tignor; Emily M Webster; Kathryn Repas; Darwin Conwell; Peter A Banks; Bechien U Wu Journal: Clin Gastroenterol Hepatol Date: 2010-09-09 Impact factor: 11.382
Authors: Satish Munigala; Divya Subramaniam; Dipti P Subramaniam; Paula Buchanan; Hong Xian; Thomas Burroughs; Guru Trikudanathan Journal: Pancreatology Date: 2017-05-29 Impact factor: 3.996
Authors: Vivek Kumar; Russell D Dolan; Allison L Yang; David X Jin; Peter A Banks; Julia McNabb-Baltar Journal: Dig Dis Sci Date: 2022-03-29 Impact factor: 3.199
Authors: Joseph C Osborne; Susan E Horsman; Kristin C Mara; Thomas C Kingsley; Robert W Kirchoff; Jonathan G Leung Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2021-12-20
Authors: Mitchell L Ramsey; Arsheya Patel; Lindsay A Sobotka; Woobeen Lim; Robert B Kirkpatrick; Samuel Han; Phil A Hart; Somashekar G Krishna; Luis F Lara; Peter J Lee; Darwin L Conwell; Georgios I Papachristou Journal: Pancreas Date: 2022-07-16 Impact factor: 3.243