A population-based study of severity in patients with acute on chronic pancreatitis

Venkata S. Akshintala, Susan Hutfless, Dhiraj Yadav, Mouen Khashab, Anne Marie O'Broin-Lennon, Martin A Makary, Kenzo Hirose, Dana K. Andersen, Anthony N Kalloo, Vikesh Singh

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1245-1250
Number of pages6
JournalPancreas
Volume42
Issue number8
DOIs
StatePublished - Nov 2013

Fingerprint

Chronic Pancreatitis
Pancreatitis
Population
Intensive Care Units
Comorbidity
Weight Loss
Mortality
Artificial Respiration
Alcoholism
Health Services
Substance-Related Disorders
Inpatients

Keywords

  • acute pancreatitis
  • chronic pancreatitis
  • severity

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

A population-based study of severity in patients with acute on chronic pancreatitis. / Akshintala, Venkata S.; Hutfless, Susan; Yadav, Dhiraj; Khashab, Mouen; O'Broin-Lennon, Anne Marie; Makary, Martin A; Hirose, Kenzo; Andersen, Dana K.; Kalloo, Anthony N; Singh, Vikesh.

In: Pancreas, Vol. 42, No. 8, 11.2013, p. 1245-1250.

Research output: Contribution to journalArticle

@article{0b9a308d9ae94509bf9e2fd1a473e79f,
title = "A population-based study of severity in patients with acute on chronic pancreatitis",
abstract = "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.",
keywords = "acute pancreatitis, chronic pancreatitis, severity",
author = "Akshintala, {Venkata S.} and Susan Hutfless and Dhiraj Yadav and Mouen Khashab and O'Broin-Lennon, {Anne Marie} and Makary, {Martin A} and Kenzo Hirose and Andersen, {Dana K.} and Kalloo, {Anthony N} and Vikesh Singh",
year = "2013",
month = "11",
doi = "10.1097/MPA.0b013e3182a85af3",
language = "English (US)",
volume = "42",
pages = "1245--1250",
journal = "Pancreas",
issn = "0885-3177",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - A population-based study of severity in patients with acute on chronic pancreatitis

AU - Akshintala, Venkata S.

AU - Hutfless, Susan

AU - Yadav, Dhiraj

AU - Khashab, Mouen

AU - O'Broin-Lennon, Anne Marie

AU - Makary, Martin A

AU - Hirose, Kenzo

AU - Andersen, Dana K.

AU - Kalloo, Anthony N

AU - Singh, Vikesh

PY - 2013/11

Y1 - 2013/11

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

VL - 42

SP - 1245

EP - 1250

JO - Pancreas

JF - Pancreas

SN - 0885-3177

IS - 8

ER -