A population-based study of severity in patients with acute on chronic pancreatitis

Venkata S. Akshintala, Susan M. Hutfless, Dhiraj Yadav, Mouen A. Khashab, Anne Marie Lennon, Martin A. Makary, Kenzo Hirose, Dana Andersen, Anthony N. Kalloo, Vikesh K. Singh

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

OBJECTIVES: The objectives of this study were to evaluate the severity of patients with acute pancreatitis (AP) on chronic pancreatitis (CP) and compare this to patients with AP without CP. METHODS: The Maryland Health Services database was queried for all adult inpatient discharges with a primary diagnosis of AP from 1994 to 2010. Acute pancreatitis on CP and AP without CP were defined by the presence of the associated diagnosis code for CP. Severity was defined as organ failure, intensive care unit stay, or mortality. RESULTS: Acute pancreatitis on CP accounted for 13.7% of all AP discharges (9747/70,944). The proportion of AP-on-CP discharges doubled during the study period (8.8% to 17.6%; P <0.0001). When compared with patients with AP without CP, AP-on-CP patients were younger, were more likely to be male and black, had higher rates of alcohol and drug abuse, and had less severe disease with lower rates of mortality, organ failure, need for mechanical ventilation, and intensive care unit stay. Among AP-on-CP patients, significant predictors of severity included advanced age, weight loss, and 2 or more comorbidities. CONCLUSIONS: Patients with AP on CP have less severe disease than do those with AP without CP. Weight loss, advanced age, and comorbidity increase the risk of severity in patients with AP on CP.

Original languageEnglish (US)
Pages (from-to)1245-1250
Number of pages6
JournalPancreas
Volume42
Issue number8
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Chronic Pancreatitis
Pancreatitis
Population
Intensive Care Units
Comorbidity
Weight Loss
Mortality
Artificial Respiration
Alcoholism
Health Services
Substance-Related Disorders
Inpatients

Keywords

  • acute pancreatitis
  • chronic pancreatitis
  • severity

ASJC Scopus subject areas

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

Cite this

Akshintala, V. S., Hutfless, S. M., Yadav, D., Khashab, M. A., Lennon, A. M., Makary, M. A., ... Singh, V. K. (2013). A population-based study of severity in patients with acute on chronic pancreatitis. Pancreas, 42(8), 1245-1250. https://doi.org/10.1097/MPA.0b013e3182a85af3

A population-based study of severity in patients with acute on chronic pancreatitis. / Akshintala, Venkata S.; Hutfless, Susan M.; Yadav, Dhiraj; Khashab, Mouen A.; Lennon, Anne Marie; Makary, Martin A.; Hirose, Kenzo; Andersen, Dana; Kalloo, Anthony N.; Singh, Vikesh K.

In: Pancreas, Vol. 42, No. 8, 11.2013, p. 1245-1250.

Research output: Contribution to journalArticle

Akshintala, VS, Hutfless, SM, Yadav, D, Khashab, MA, Lennon, AM, Makary, MA, Hirose, K, Andersen, D, Kalloo, AN & Singh, VK 2013, 'A population-based study of severity in patients with acute on chronic pancreatitis', Pancreas, vol. 42, no. 8, pp. 1245-1250. https://doi.org/10.1097/MPA.0b013e3182a85af3
Akshintala VS, Hutfless SM, Yadav D, Khashab MA, Lennon AM, Makary MA et al. A population-based study of severity in patients with acute on chronic pancreatitis. Pancreas. 2013 Nov;42(8):1245-1250. https://doi.org/10.1097/MPA.0b013e3182a85af3
Akshintala, Venkata S. ; Hutfless, Susan M. ; Yadav, Dhiraj ; Khashab, Mouen A. ; Lennon, Anne Marie ; Makary, Martin A. ; Hirose, Kenzo ; Andersen, Dana ; Kalloo, Anthony N. ; Singh, Vikesh K. / A population-based study of severity in patients with acute on chronic pancreatitis. In: Pancreas. 2013 ; Vol. 42, No. 8. pp. 1245-1250.
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abstract = "OBJECTIVES: The objectives of this study were to evaluate the severity of patients with acute pancreatitis (AP) on chronic pancreatitis (CP) and compare this to patients with AP without CP. METHODS: The Maryland Health Services database was queried for all adult inpatient discharges with a primary diagnosis of AP from 1994 to 2010. Acute pancreatitis on CP and AP without CP were defined by the presence of the associated diagnosis code for CP. Severity was defined as organ failure, intensive care unit stay, or mortality. RESULTS: Acute pancreatitis on CP accounted for 13.7{\%} of all AP discharges (9747/70,944). The proportion of AP-on-CP discharges doubled during the study period (8.8{\%} to 17.6{\%}; P <0.0001). When compared with patients with AP without CP, AP-on-CP patients were younger, were more likely to be male and black, had higher rates of alcohol and drug abuse, and had less severe disease with lower rates of mortality, organ failure, need for mechanical ventilation, and intensive care unit stay. Among AP-on-CP patients, significant predictors of severity included advanced age, weight loss, and 2 or more comorbidities. CONCLUSIONS: Patients with AP on CP have less severe disease than do those with AP without CP. Weight loss, advanced age, and comorbidity increase the risk of severity in patients with AP on CP.",
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AU - Lennon, Anne Marie

AU - Makary, Martin A.

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AU - Singh, Vikesh K.

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