TY - JOUR
T1 - A Study on the Effect of Patient Characteristics, Geographical Utilization, and Patient Outcomes for Total Pancreatectomy Alone and Total Pancreatectomy with Islet Autotransplantation in Patients with Pancreatitis in the United States
AU - Lara, Luis F.
AU - Bellin, Melena D.
AU - Ugbarugba, Emmanuel
AU - Nathan, Jaimie D.
AU - Witkowski, Piotr
AU - Wijkstrom, Martin
AU - Steel, Jennifer L.
AU - Smith, Kerrington D.
AU - Singh, Vikesh K.
AU - Schwarzenberg, Sarah J.
AU - Pruett, Timothy L.
AU - Naziruddin, Bashoo
AU - Long-Simpson, Leslie
AU - Kirchner, Varvara A.
AU - Gardner, Timothy B.
AU - Freeman, Martin L.
AU - Dunn, Ty B.
AU - Chinnakotla, Srinath
AU - Beilman, Gregory J.
AU - Adams, David B.
AU - Morgan, Katherine A.
AU - Abu-El-Haija, Maisam A.
AU - Ahmad, Syed
AU - Posselt, Andrew M.
AU - Hughes, Michael G.
AU - Conwell, Darwin L.
N1 - Funding Information:
Data were extracted from the Healthcare Cost and Utilization Project (HCUP; www.hcup-us.ahrq.gov) National Inpatient Sample (NIS) database, which was previously named Nationwide Inpatient Sample until the methodology to capture data was revised in 2012. The HCUP is sponsored by the Agency for Healthcare Quality and Research through a federal-state-industry partnership. The NIS database is an administrative, deidentified, and publically accessible database, which produces national estimates of hospital inpatient stays by compiling a 20% stratified sample of discharges, which is extracted from the State Inpatient Databases. This represents more than 97% of the population of the United States. The sample size of diagnoses and outcomes obtained by the NIS are representative of national outcomes.27,28 Data are captured from the hospitals from 48 States and the District of Columbia, which contribute data regardless of payer, so it also includes uninsured patients. The information is used in research and by policy makers to estimate health care utilization, access to care, quality of care, financial charges, and outcomes and for health care decision-making at the national, state, and local levels.
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Objectives A selective therapy for pancreatitis is total pancreatectomy and islet autotransplantation. Outcomes and geographical variability of patients who had total pancreatectomy (TP) alone or total pancreatectomy with islet autotransplantation (TPIAT) were assessed. Methods Data were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample database. Weighed univariate and multivariate analyses were performed to determine the effect of measured variables on outcomes. Results Between 2002 and 2013, there were 1006 TP and 825 TPIAT in patients with a diagnosis of chronic pancreatitis, and 1705 TP and 830 TPIAT for any diagnosis of pancreatitis. The majority of the TP and TPIAT were performed in larger urban hospitals. Costs were similar for TP and TPIAT for chronic pancreatitis but were lower for TPIAT compared with TP for any type of pancreatitis. The trend for TP and TPIAT was significant in all geographical areas during the study period. Conclusions There is an increasing trend of both TP and TPIAT. Certain groups are more likely to be offered TPIAT compared with TP alone. More data are needed to understand disparities and barriers to TPIAT, and long-term outcomes of TPIAT such as pain control and glucose intolerance need further study.
AB - Objectives A selective therapy for pancreatitis is total pancreatectomy and islet autotransplantation. Outcomes and geographical variability of patients who had total pancreatectomy (TP) alone or total pancreatectomy with islet autotransplantation (TPIAT) were assessed. Methods Data were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample database. Weighed univariate and multivariate analyses were performed to determine the effect of measured variables on outcomes. Results Between 2002 and 2013, there were 1006 TP and 825 TPIAT in patients with a diagnosis of chronic pancreatitis, and 1705 TP and 830 TPIAT for any diagnosis of pancreatitis. The majority of the TP and TPIAT were performed in larger urban hospitals. Costs were similar for TP and TPIAT for chronic pancreatitis but were lower for TPIAT compared with TP for any type of pancreatitis. The trend for TP and TPIAT was significant in all geographical areas during the study period. Conclusions There is an increasing trend of both TP and TPIAT. Certain groups are more likely to be offered TPIAT compared with TP alone. More data are needed to understand disparities and barriers to TPIAT, and long-term outcomes of TPIAT such as pain control and glucose intolerance need further study.
KW - chronic pancreatitis
KW - health care utilization
KW - pancreatitis
KW - total pancreatectomy
KW - total pancreatectomy with islet autotransplantation
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UR - http://www.scopus.com/inward/citedby.url?scp=85073183284&partnerID=8YFLogxK
U2 - 10.1097/MPA.0000000000001405
DO - 10.1097/MPA.0000000000001405
M3 - Article
C2 - 31593020
AN - SCOPUS:85073183284
SN - 0885-3177
VL - 48
SP - 1204
EP - 1211
JO - Pancreas
JF - Pancreas
IS - 9
ER -