Nieto Luis M, Salazar Miguel, Kinnucan Jami, Lukens Frank J, Argueta Pedro Palacios
WellStar Atlanta Medical Center, 433 Highland Ave Ne apt 1434, Atlanta, GA, 30312, USA.
Department of Gastroenterology, University of California Riverside, Riverside, CA, USA.
Dig Dis Sci. 2023 Feb;68(2):423-433. doi: 10.1007/s10620-022-07798-w. Epub 2022 Dec 24.
BACKGROUND/OBJECTIVES: Data regarding incidence, health-care burden, and predictors for readmission in patients with acute alcoholic pancreatitis (AAP) is scarce. We aim to identify incidence, health-care burden, and predictors of readmission over an 11-month period.
Retrospective cohort study using the 2016 National Readmission Database of adult patients admitted with a principal diagnosis of AAP in January and 11-month readmission follow up for all-cause readmission. Incidence of all-cause readmission, mortality rate, morbidity, length of stay (LOS), total hospitalization charges and costs were evaluated. Independent risk factors for all-cause readmission were identified using a Cox multivariate logistic regression analysis.
A total of 6633 patients were included in the study. The mean age was 45.7 years and 28.9% of patients were female. 73.1% of patients had a modified BISAP score of 0. The 11-month readmission rate was 43.1%. The main cause of readmission was another episode of AAP. The mortality rate of readmission was 0.5% and the mortality rate during the index admission (IA) was 1.1% (P = 0.03). The mean LOS, total hospitalization charges and costs for readmission were 4.5 days, $34,307 and $8958, respectively. Independent predictors of readmission were Charlson Comorbidity Index score of ≥ 3, associated chronic alcoholic pancreatitis, and chronic pancreatitis (CP) from other causes.
Among patients admitted with AAP, the 11-month readmission rate was 43.1%. Over one-third of readmissions were due to another episode of AAP. Readmission associated with significant resource utilization. Special attention should be placed in patients with underlying CP due to the increased risk of readmission.
背景/目的:关于急性酒精性胰腺炎(AAP)患者再入院率、医疗负担及预测因素的数据较少。我们旨在确定11个月期间的再入院率、医疗负担及预测因素。
采用回顾性队列研究,利用2016年国家再入院数据库,纳入1月份以AAP为主要诊断入院的成年患者,并对全因再入院进行11个月的随访。评估全因再入院率、死亡率、发病率、住院时间(LOS)、总住院费用。采用Cox多因素逻辑回归分析确定全因再入院的独立危险因素。
共纳入6633例患者。平均年龄45.7岁,28.9%为女性。73.1%的患者改良BISAP评分为0。11个月再入院率为43.1%。再入院的主要原因是再次发生AAP。再入院死亡率为0.5%,首次入院(IA)期间死亡率为1.1%(P = 0.03)。再入院的平均住院时间、总住院费用分别为4.5天、34307美元和8958美元。再入院的独立预测因素为Charlson合并症指数评分≥3、合并慢性酒精性胰腺炎及其他原因所致慢性胰腺炎(CP)。
AAP入院患者中,11个月再入院率为43.1%。超过三分之一的再入院是由于再次发生AAP。再入院与大量资源利用相关。由于再入院风险增加,应特别关注合并CP的患者。