TY - JOUR
T1 - A population-based study of severity in patients with acute on chronic pancreatitis
AU - Akshintala, Venkata S.
AU - Hutfless, Susan M.
AU - Yadav, Dhiraj
AU - Khashab, Mouen A.
AU - Lennon, Anne Marie
AU - Makary, Martin A.
AU - Hirose, Kenzo
AU - Andersen, Dana
AU - Kalloo, Anthony N.
AU - Singh, Vikesh K.
PY - 2013/11/1
Y1 - 2013/11/1
N2 - OBJECTIVES: The objectives of this study were to evaluate the severity of patients with acute pancreatitis (AP) on chronic pancreatitis (CP) and compare this to patients with AP without CP. METHODS: The Maryland Health Services database was queried for all adult inpatient discharges with a primary diagnosis of AP from 1994 to 2010. Acute pancreatitis on CP and AP without CP were defined by the presence of the associated diagnosis code for CP. Severity was defined as organ failure, intensive care unit stay, or mortality. RESULTS: Acute pancreatitis on CP accounted for 13.7% of all AP discharges (9747/70,944). The proportion of AP-on-CP discharges doubled during the study period (8.8% to 17.6%; P < 0.0001). When compared with patients with AP without CP, AP-on-CP patients were younger, were more likely to be male and black, had higher rates of alcohol and drug abuse, and had less severe disease with lower rates of mortality, organ failure, need for mechanical ventilation, and intensive care unit stay. Among AP-on-CP patients, significant predictors of severity included advanced age, weight loss, and 2 or more comorbidities. CONCLUSIONS: Patients with AP on CP have less severe disease than do those with AP without CP. Weight loss, advanced age, and comorbidity increase the risk of severity in patients with AP on CP.
AB - OBJECTIVES: The objectives of this study were to evaluate the severity of patients with acute pancreatitis (AP) on chronic pancreatitis (CP) and compare this to patients with AP without CP. METHODS: The Maryland Health Services database was queried for all adult inpatient discharges with a primary diagnosis of AP from 1994 to 2010. Acute pancreatitis on CP and AP without CP were defined by the presence of the associated diagnosis code for CP. Severity was defined as organ failure, intensive care unit stay, or mortality. RESULTS: Acute pancreatitis on CP accounted for 13.7% of all AP discharges (9747/70,944). The proportion of AP-on-CP discharges doubled during the study period (8.8% to 17.6%; P < 0.0001). When compared with patients with AP without CP, AP-on-CP patients were younger, were more likely to be male and black, had higher rates of alcohol and drug abuse, and had less severe disease with lower rates of mortality, organ failure, need for mechanical ventilation, and intensive care unit stay. Among AP-on-CP patients, significant predictors of severity included advanced age, weight loss, and 2 or more comorbidities. CONCLUSIONS: Patients with AP on CP have less severe disease than do those with AP without CP. Weight loss, advanced age, and comorbidity increase the risk of severity in patients with AP on CP.
KW - acute pancreatitis
KW - chronic pancreatitis
KW - severity
UR - http://www.scopus.com/inward/record.url?scp=84887283869&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84887283869&partnerID=8YFLogxK
U2 - 10.1097/MPA.0b013e3182a85af3
DO - 10.1097/MPA.0b013e3182a85af3
M3 - Article
C2 - 24152950
AN - SCOPUS:84887283869
SN - 0885-3177
VL - 42
SP - 1245
EP - 1250
JO - Pancreas
JF - Pancreas
IS - 8
ER -