TY - JOUR
T1 - Hospital admission volume does not impact the in-hospital mortality of acute pancreatitis
AU - Kamal, Ayesha
AU - Sinha, Amitasha
AU - Hutfless, Susan
AU - Afghani, Elham
AU - Faghih, Mahya
AU - Khashab, Mouen A.
AU - Lennon, Anne Marie
AU - Yadav, Dhiraj
AU - Makary, Martin A.
AU - Andersen, Dana
AU - Kalloo, Anthony N.
AU - Singh, Vikesh K.
N1 - Publisher Copyright:
© 2016 International Hepato-Pancreato-Biliary Association Inc.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background Multiple factors influence mortality in Acute Pancreatitis (AP). Methods To evaluate the association of demographic, clinical, and hospital factors with the in-hospital mortality of AP using a population-based administrative database. The Maryland HSCRC database was queried for adult (≥18 years) admissions with primary diagnosis of AP between 1/94-12/10. Organ failure (OF), interventions, hospital characteristics and referral status were evaluated. Results There were 72,601 AP admissions across 48 hospitals in Maryland with 885 (1.2%) deaths. A total of 1657 (2.3%) were transfer patients, of whom 101 (6.1%) died. Multisystem OF was present in 1078 (1.5%), of whom 306 (28.4%) died. On univariable analysis, age, male gender, transfer status, comorbidity, OF, all interventions, and all hospital characteristics were significantly associated with mortality; however, only age, transfer status, OF, interventions, and large hospital size were significant in the adjusted analysis. Patients with commercial health insurance had significantly less mortality than those with other forms of insurance (OR 0.65, 95% CI: 0.52, 0.82, p = 0.0002). Conclusion OF is the strongest predictor of mortality in AP after adjusting for demographic, clinical, and hospital characteristics. Admission to HV or teaching hospital has no survival benefit in AP after adjusting for OF and transfer status.
AB - Background Multiple factors influence mortality in Acute Pancreatitis (AP). Methods To evaluate the association of demographic, clinical, and hospital factors with the in-hospital mortality of AP using a population-based administrative database. The Maryland HSCRC database was queried for adult (≥18 years) admissions with primary diagnosis of AP between 1/94-12/10. Organ failure (OF), interventions, hospital characteristics and referral status were evaluated. Results There were 72,601 AP admissions across 48 hospitals in Maryland with 885 (1.2%) deaths. A total of 1657 (2.3%) were transfer patients, of whom 101 (6.1%) died. Multisystem OF was present in 1078 (1.5%), of whom 306 (28.4%) died. On univariable analysis, age, male gender, transfer status, comorbidity, OF, all interventions, and all hospital characteristics were significantly associated with mortality; however, only age, transfer status, OF, interventions, and large hospital size were significant in the adjusted analysis. Patients with commercial health insurance had significantly less mortality than those with other forms of insurance (OR 0.65, 95% CI: 0.52, 0.82, p = 0.0002). Conclusion OF is the strongest predictor of mortality in AP after adjusting for demographic, clinical, and hospital characteristics. Admission to HV or teaching hospital has no survival benefit in AP after adjusting for OF and transfer status.
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U2 - 10.1016/j.hpb.2016.10.013
DO - 10.1016/j.hpb.2016.10.013
M3 - Article
C2 - 27887788
AN - SCOPUS:85007238831
SN - 1365-182X
VL - 19
SP - 21
EP - 28
JO - HPB
JF - HPB
IS - 1
ER -