Early readmission in acute pancreatitis: Incidence and risk factors

Objectives: Early unplanned readmission is a potential target for quality improvement and cost reduction. The aims of this study were to (i) determine the frequency of early readmission following hospitalization for acute pancreatitis (AP) and (ii) identify risk factors for early readmission in patients hospitalized for AP. Methods: A retrospective, observational cohort study was performed including all inpatients with AP at a tertiary-care hospital between June 2005 and December 2007. Early readmission was defined as admission to the hospital or reevaluation in the emergency department within 30 days of discharge. We analyzed demographics, etiology, markers of severity (according to Atlanta symposium), comorbidities, complications, therapeutic interventions, and discharge symptoms as potential risk factors for readmission. Results: There were a total of 248 patients discharged with AP during the study period, of whom 19% (47/248) had an early readmission. Median time to readmission was 9 days (interquartile range, 5-15). Median rehospitalization length of stay was 4 days (2.5-8). In multivariate analysis, the strongest risk factors for early readmission included (i) gastrointestinal symptoms (nausea, vomiting, or diarrhea) at discharge (odds ratio (OR) 44.2; 95% confidence interval (CI) 4.1-472.1); (ii) discharge on less than a solid diet (OR 23.8; 95% CI 4.8-118.2); and (iii) moderate to heavy alcohol use (OR 10.1; 95% CI 1.2-82.6). Conclusions: (i) Early readmission is a common occurrence in AP. (ii) Risk factors for early readmission included moderate to heavy alcohol use, persistent symptoms, and diet at the time of discharge.