Gastroenterology & Hepatology, University of Utah Health, Salt Lake City, UT, USA.
Department of Medicine, Jersey Shore University Medical Center, Neptune City, NJ, USA.
Dig Dis Sci. 2023 Jun;68(6):2196-2203. doi: 10.1007/s10620-023-07830-7. Epub 2023 Jan 18.
Acute pancreatitis is the most common gastrointestinal cause of hospital admissions in the United States of which biliary or gallstone disease is the most common inciting factor.
Estimate the effects of frailty on burden, costs, and causes for hospitalization in patients with acute biliary pancreatitis.
We analysed the Nationwide Readmission Database from 2016 to 2019 for patients with acute biliary pancreatitis. Patients were categorized into two groups, frail and non-frail, based on the Hospital Frailty Risk Score. Logistic and Cox regression were used to predict the impact of frailty on 30-day readmission, length of stay, mortality, and costs.
162,202 index hospitalizations with acute biliary pancreatitis without cholangitis were identified, of whom 59.2% (n = 96,045) were female and 22.49% (n = 36,475) were classified as frail. Readmissions within 30 days were higher among frail patients (12.58% vs 7.09%, P < 0.001) compared to non-frail patients, respectively. Regression modeling showed that frail patients had higher odds of readmission (OR 1.32; 95% CI 1.24-1.42, P < 0.001), longer lengths of stay (8.18 days vs 4.11 days), and higher average costs of hospitalization ($21,511 vs $12,261) compared to non-frail patients, respectively. Cox regression showed that frail patients had a higher risk of mortality (HR 5.43; 95% Cl 4.06-7.29, P < 0.001) compared to non-frail patients, respectively.
Frailty is independently associated with higher mortality and burden of healthcare utilization in patients with acute biliary pancreatitis. We suggest using the Hospital Frailty Risk Score as part of the treatment algorithm in patients with acute biliary pancreatitis.
在美国，急性胰腺炎是最常见的胃肠道住院原因，其中胆石症或胆囊疾病是最常见的诱发因素。
评估衰弱对急性胆源性胰腺炎患者住院负担、费用和原因的影响。
我们分析了 2016 年至 2019 年全国再入院数据库中患有急性胆源性胰腺炎的患者。根据医院衰弱风险评分，患者分为衰弱组和非衰弱组。使用逻辑回归和 Cox 回归预测衰弱对 30 天再入院、住院时间、死亡率和费用的影响。
共确定了 162202 例无胆管炎的急性胆源性胰腺炎指数住院患者，其中 59.2%（n=96045）为女性，22.49%（n=36475）为衰弱。与非衰弱患者相比，衰弱患者 30 天内再入院率更高（12.58% vs 7.09%，P<0.001）。回归模型显示，与非衰弱患者相比，衰弱患者再入院的可能性更高（OR 1.32；95%CI 1.24-1.42，P<0.001），住院时间更长（8.18 天 vs 4.11 天），住院平均费用更高（21511 美元 vs 12261 美元）。Cox 回归显示，与非衰弱患者相比，衰弱患者的死亡率更高（HR 5.43；95%Cl 4.06-7.29，P<0.001）。
衰弱与急性胆源性胰腺炎患者的死亡率和医疗保健利用负担增加独立相关。我们建议在急性胆源性胰腺炎患者的治疗方案中使用医院衰弱风险评分。
