Hospital admission volume does not impact the in-hospital mortality of acute pancreatitis

Ayesha Kamal, Amitasha Sinha, Susan M. Hutfless, Elham Afghani, Mahya Faghih, Mouen A. Khashab, Anne Marie Lennon, Dhiraj Yadav, Martin A. Makary, Dana Andersen, Anthony N. Kalloo, Vikesh K. Singh

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)21-28
Number of pages8
JournalHPB
Volume19
Issue number1
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Fingerprint

Hospital Mortality
Pancreatitis
Mortality
Demography
Health Facility Size
Databases
Patient Transfer
Health Insurance
Insurance
Teaching Hospitals
Comorbidity
Referral and Consultation
Survival
Population

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Kamal, A., Sinha, A., Hutfless, S. M., Afghani, E., Faghih, M., Khashab, M. A., ... Singh, V. K. (2017). Hospital admission volume does not impact the in-hospital mortality of acute pancreatitis. HPB, 19(1), 21-28. https://doi.org/10.1016/j.hpb.2016.10.013

Hospital admission volume does not impact the in-hospital mortality of acute pancreatitis. / Kamal, Ayesha; Sinha, Amitasha; Hutfless, Susan M.; Afghani, Elham; Faghih, Mahya; Khashab, Mouen A.; Lennon, Anne Marie; Yadav, Dhiraj; Makary, Martin A.; Andersen, Dana; Kalloo, Anthony N.; Singh, Vikesh K.

In: HPB, Vol. 19, No. 1, 01.01.2017, p. 21-28.

Research output: Contribution to journalArticle

Kamal, A, Sinha, A, Hutfless, SM, Afghani, E, Faghih, M, Khashab, MA, Lennon, AM, Yadav, D, Makary, MA, Andersen, D, Kalloo, AN & Singh, VK 2017, 'Hospital admission volume does not impact the in-hospital mortality of acute pancreatitis', HPB, vol. 19, no. 1, pp. 21-28. https://doi.org/10.1016/j.hpb.2016.10.013
Kamal A, Sinha A, Hutfless SM, Afghani E, Faghih M, Khashab MA et al. Hospital admission volume does not impact the in-hospital mortality of acute pancreatitis. HPB. 2017 Jan 1;19(1):21-28. https://doi.org/10.1016/j.hpb.2016.10.013
Kamal, Ayesha ; Sinha, Amitasha ; Hutfless, Susan M. ; Afghani, Elham ; Faghih, Mahya ; Khashab, Mouen A. ; Lennon, Anne Marie ; Yadav, Dhiraj ; Makary, Martin A. ; Andersen, Dana ; Kalloo, Anthony N. ; Singh, Vikesh K. / Hospital admission volume does not impact the in-hospital mortality of acute pancreatitis. In: HPB. 2017 ; Vol. 19, No. 1. pp. 21-28.
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abstract = "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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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.

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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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