A randomized controlled trial of home monitoring versus hospitalization for mild non-alcoholic acute interstitial pancreatitis: A pilot study

Ali Tüzün Ince, Hakan Senturk, Vikesh Singh, Kemal Yildiz, Ahmet Danalioʇlu, Ahmet Çinar, Ömer Uysal, Orhan Kocaman, Birol Baysal, Ahmet Gurakar

Research output: Contribution to journalArticle

Abstract

Background/Objectives: Acute pancreatitis (AP) is a disease typically requiring in-hospital treatment. We conducted a trial to assess the feasibility of early discharge from the hospital for patients with mild nonalcoholic acute pancreatitis (NAAP). Methods: Eighty-four patients with mild NAAP were randomized to home or hospital groups after a short hospital stay (≤24 h). AP was defined by the revised Atlanta criteria. Mild AP was defined as an Imrie score≤5 and a harmless acute pancreatitis score (HAPS)≤2 in the first 24-h of presentation. A nurse visited all patients in the home group on the 2nd, 3rd and 5th days. All patients presented for follow-up in clinic on the 7th, 14th, and 30th days. The primary outcome was the time to resolution of pain. Secondary outcomes evaluated included time to resumption of an oral diet, 30 day hospital readmission rate as well as the total costs associated with either approach to care. Results: There was no difference between the groups with regards to demographics, prognostic severity scores, symptoms, and biliary findings. No patients developed organ failure, pancreatic necrosis, or died in either group. Time to the resolution of pain and resumption of solid food intake were similar. Three (3.6%) patients required readmission within 30 days, 1 from home and 2 from the hospital groups. The total cost was significantly less in home group ($139 ± 73 vs. $951 ± 715, p <0.001). Conclusions: Mild NAAP can be safely treated at home with regular visits by a nurse under the supervision of a physician. Widespread adoption of this practice may result in large cost savings.

Original languageEnglish (US)
Pages (from-to)174-178
Number of pages5
JournalPancreatology
Volume14
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Pancreatitis
Hospitalization
Randomized Controlled Trials
Group Homes
Patient Readmission
Nurses
Costs and Cost Analysis
Pain
Cost Savings
Patient Discharge
Length of Stay
Necrosis
Eating
Demography
Diet
Physicians

Keywords

  • Acute interstitial pancreatitis
  • Home monitoring
  • Home therapy
  • Mild acute pancreatitis

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Hepatology

Cite this

A randomized controlled trial of home monitoring versus hospitalization for mild non-alcoholic acute interstitial pancreatitis : A pilot study. / Ince, Ali Tüzün; Senturk, Hakan; Singh, Vikesh; Yildiz, Kemal; Danalioʇlu, Ahmet; Çinar, Ahmet; Uysal, Ömer; Kocaman, Orhan; Baysal, Birol; Gurakar, Ahmet.

In: Pancreatology, Vol. 14, No. 3, 2014, p. 174-178.

Research output: Contribution to journalArticle

Ince, Ali Tüzün ; Senturk, Hakan ; Singh, Vikesh ; Yildiz, Kemal ; Danalioʇlu, Ahmet ; Çinar, Ahmet ; Uysal, Ömer ; Kocaman, Orhan ; Baysal, Birol ; Gurakar, Ahmet. / A randomized controlled trial of home monitoring versus hospitalization for mild non-alcoholic acute interstitial pancreatitis : A pilot study. In: Pancreatology. 2014 ; Vol. 14, No. 3. pp. 174-178.
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abstract = "Background/Objectives: Acute pancreatitis (AP) is a disease typically requiring in-hospital treatment. We conducted a trial to assess the feasibility of early discharge from the hospital for patients with mild nonalcoholic acute pancreatitis (NAAP). Methods: Eighty-four patients with mild NAAP were randomized to home or hospital groups after a short hospital stay (≤24 h). AP was defined by the revised Atlanta criteria. Mild AP was defined as an Imrie score≤5 and a harmless acute pancreatitis score (HAPS)≤2 in the first 24-h of presentation. A nurse visited all patients in the home group on the 2nd, 3rd and 5th days. All patients presented for follow-up in clinic on the 7th, 14th, and 30th days. The primary outcome was the time to resolution of pain. Secondary outcomes evaluated included time to resumption of an oral diet, 30 day hospital readmission rate as well as the total costs associated with either approach to care. Results: There was no difference between the groups with regards to demographics, prognostic severity scores, symptoms, and biliary findings. No patients developed organ failure, pancreatic necrosis, or died in either group. Time to the resolution of pain and resumption of solid food intake were similar. Three (3.6{\%}) patients required readmission within 30 days, 1 from home and 2 from the hospital groups. The total cost was significantly less in home group ($139 ± 73 vs. $951 ± 715, p <0.001). Conclusions: Mild NAAP can be safely treated at home with regular visits by a nurse under the supervision of a physician. Widespread adoption of this practice may result in large cost savings.",
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AU - Ince, Ali Tüzün

AU - Senturk, Hakan

AU - Singh, Vikesh

AU - Yildiz, Kemal

AU - Danalioʇlu, Ahmet

AU - Çinar, Ahmet

AU - Uysal, Ömer

AU - Kocaman, Orhan

AU - Baysal, Birol

AU - Gurakar, Ahmet

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AB - Background/Objectives: Acute pancreatitis (AP) is a disease typically requiring in-hospital treatment. We conducted a trial to assess the feasibility of early discharge from the hospital for patients with mild nonalcoholic acute pancreatitis (NAAP). Methods: Eighty-four patients with mild NAAP were randomized to home or hospital groups after a short hospital stay (≤24 h). AP was defined by the revised Atlanta criteria. Mild AP was defined as an Imrie score≤5 and a harmless acute pancreatitis score (HAPS)≤2 in the first 24-h of presentation. A nurse visited all patients in the home group on the 2nd, 3rd and 5th days. All patients presented for follow-up in clinic on the 7th, 14th, and 30th days. The primary outcome was the time to resolution of pain. Secondary outcomes evaluated included time to resumption of an oral diet, 30 day hospital readmission rate as well as the total costs associated with either approach to care. Results: There was no difference between the groups with regards to demographics, prognostic severity scores, symptoms, and biliary findings. No patients developed organ failure, pancreatic necrosis, or died in either group. Time to the resolution of pain and resumption of solid food intake were similar. Three (3.6%) patients required readmission within 30 days, 1 from home and 2 from the hospital groups. The total cost was significantly less in home group ($139 ± 73 vs. $951 ± 715, p <0.001). Conclusions: Mild NAAP can be safely treated at home with regular visits by a nurse under the supervision of a physician. Widespread adoption of this practice may result in large cost savings.

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