Mortality and Readmission Rates in Patients with Chronic Pancreatitis and Morbid Obesity or Prior Bariatric Surgery: A National Readmission Database Analysis.

BACKGROUND

The impact of weight management strategies on mortality and readmission in chronic pancreatitis patients remains unclear. This study uses the Nationwide Readmissions Database to assess the effects of prior bariatric surgery on these outcomes in patients with CP.

METHODS

Patients with CP and severe obesity or history of bariatric surgery were extracted in the NRD from 2016 to 2022. Demographics, hospital/operative factors, and comorbidities were identified as independent risk factors. 90-day readmission and mortality were identified as outcomes. Univariate regressions determined differences in characteristics for patients with and without prior bariatric surgery, and independent risk factors were used to construct multivariable logistic regression models for these outcomes.

RESULTS

A total of 40,685 patients with CP and either severe obesity or history of bariatric surgery were identified, with 31.4% of patients having undergone prior bariatric surgery. Charlson comorbidity scores for CP patients with prior bariatric surgery were lower compared to individual with severe obesity alone (1.6 ± 1.7 vs. 2.85 ± 2.3). Bariatric surgery was associated with a higher risk of readmission (OR:1.77 [1.64,1.91], p < 0.05). While no significant difference in mortality was found between the two groups (5.4% vs 4.8% OR:1.10 [0.97,1.25], p = 0.15), protein malnutrition was associated with a significantly increased risk of mortality in postsurgical patients (OR: 2.35, 95% CI [2.06,2.70]).

CONCLUSIONS

Metabolic surgery increases the risk of readmission in patients with CP compared to obese CP patients who never underwent bariatric surgery. However, it does not alter mortality rates. Further prospective studies are needed to explore the underlying mechanisms and potential prevention strategies.