Early Hemoconcentration Is Associated with Increased Opioid Use in Hospitalized Patients with Acute Pancreatitis

Nasim Parsa, Mahya Faghih, Francisco Garcia Gonzalez, Robert A. Moran, Ayesha Kamal, Niloofar Y. Jalaly, Haitham Al-Grain, Venkata S. Akshintala, Martin A Makary, Mouen Khashab, Anthony N Kalloo, Vikesh Singh

Research output: Contribution to journalArticle

Abstract

Objectives Opioids are commonly required for abdominal pain in hospitalized patients with acute pancreatitis (AP). The factors associated with increased opioid requirements are unknown. Methods The medical records of adult inpatients with AP from 2006 to 2016 were reviewed. Patients with chronic pancreatitis, psychiatric comorbidities, intubation, chronic opioid, and illicit drug use were excluded. The total quantity of opioids required during the first 7 days of hospitalization was converted to oral morphine equivalents (OME), divided by the number of days opioids were required to obtain the mean OME per day(s) of treatment (MOME). Multiple regression analysis was performed to identify factors associated with MOME. Results A total of 267 patients were included. The mean (standard deviation) age was 46.9 (13.9) years and 56% were males. The most common etiology was alcohol (55.4%). The mean (standard deviation) MOME was 59.1 (54.5) mg. Although age (P = 0.008), black race (P = 0.004), and first episode of AP (P = 0.049) were associated with a lower MOME, early hemoconcentration (hematocrit ≥44%) (P < 0.001) was associated with an increased MOME. Conclusions Early hemoconcentration is associated with an increased opioid requirement in hospitalized patients with AP. The impact of fluid therapy in these patients merits prospective study.

Original languageEnglish (US)
Pages (from-to)193-198
Number of pages6
JournalPancreas
Volume48
Issue number2
DOIs
StatePublished - Feb 1 2019

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Pancreatitis
Opioid Analgesics
Morphine
Fluid Therapy
Chronic Pancreatitis
Street Drugs
Hematocrit
Intubation
Abdominal Pain
Medical Records
Psychiatry
Comorbidity
Inpatients
Hospitalization
Regression Analysis
Alcohols
Prospective Studies

Keywords

  • acute pancreatitis
  • hemoconcentration
  • opioids

ASJC Scopus subject areas

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

Cite this

Early Hemoconcentration Is Associated with Increased Opioid Use in Hospitalized Patients with Acute Pancreatitis. / Parsa, Nasim; Faghih, Mahya; Gonzalez, Francisco Garcia; Moran, Robert A.; Kamal, Ayesha; Jalaly, Niloofar Y.; Al-Grain, Haitham; Akshintala, Venkata S.; Makary, Martin A; Khashab, Mouen; Kalloo, Anthony N; Singh, Vikesh.

In: Pancreas, Vol. 48, No. 2, 01.02.2019, p. 193-198.

Research output: Contribution to journalArticle

Parsa, Nasim ; Faghih, Mahya ; Gonzalez, Francisco Garcia ; Moran, Robert A. ; Kamal, Ayesha ; Jalaly, Niloofar Y. ; Al-Grain, Haitham ; Akshintala, Venkata S. ; Makary, Martin A ; Khashab, Mouen ; Kalloo, Anthony N ; Singh, Vikesh. / Early Hemoconcentration Is Associated with Increased Opioid Use in Hospitalized Patients with Acute Pancreatitis. In: Pancreas. 2019 ; Vol. 48, No. 2. pp. 193-198.
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AU - Faghih, Mahya

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AU - Kamal, Ayesha

AU - Jalaly, Niloofar Y.

AU - Al-Grain, Haitham

AU - Akshintala, Venkata S.

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AB - Objectives Opioids are commonly required for abdominal pain in hospitalized patients with acute pancreatitis (AP). The factors associated with increased opioid requirements are unknown. Methods The medical records of adult inpatients with AP from 2006 to 2016 were reviewed. Patients with chronic pancreatitis, psychiatric comorbidities, intubation, chronic opioid, and illicit drug use were excluded. The total quantity of opioids required during the first 7 days of hospitalization was converted to oral morphine equivalents (OME), divided by the number of days opioids were required to obtain the mean OME per day(s) of treatment (MOME). Multiple regression analysis was performed to identify factors associated with MOME. Results A total of 267 patients were included. The mean (standard deviation) age was 46.9 (13.9) years and 56% were males. The most common etiology was alcohol (55.4%). The mean (standard deviation) MOME was 59.1 (54.5) mg. Although age (P = 0.008), black race (P = 0.004), and first episode of AP (P = 0.049) were associated with a lower MOME, early hemoconcentration (hematocrit ≥44%) (P < 0.001) was associated with an increased MOME. Conclusions Early hemoconcentration is associated with an increased opioid requirement in hospitalized patients with AP. The impact of fluid therapy in these patients merits prospective study.

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