Abstract

INTRODUCTION: The rates of obesity continue to increase in the US and may have an adverse effect on clinical outcomes in patients with pancreatitis. As the management of acute pancreatitis has improved over the past 2 decades, we sought to evaluate the impact of obesity on patients with pancreatitis using contemporary inpatient data. METHODS: The Nationwide Inpatient Sample (2016) was used to identify all adult inpatients older than 18 years with a primary diagnosis of acute and chronic pancreatitis. Primary outcomes included mortality, acute renal failure, acute respiratory failure and septic shock as well as secondary outcomes included length of stay and hospital cost were analyzed. RESULTS: During 2016, the national estimate for patients hospitalized with acute and chronic pancreatitis was 519,035. Of these, 70,670 (13.6%) patients carried a diagnosis of obesity. Patients hospitalized for pancreatitis with and without obesity had similar baseline characteristics. Patients with obesity were more likely to be younger (35% vs 31%, P < 0.001), female (35% vs 31%, P < 0.001), and Hispanic (15% vs 11%, P < 0.001). These patients presented to smaller hospitals (70% vs 48%, P < 0.001). Additionally, the etiology of pancreatitis was less likely to be a biliary source (67% vs 79%, P < 0.001). Obese patients had a lower likelihood of mortality (1.5% vs 2.1%, P < 0.001) and septic shock (2.7% vs 2.9%, P < 0.001) but were more likely to have respiratory failure (7.9% vs 7.2%, P < 0.001). Both populations had a similar median length of stay (4) however obese patients had a higher cost of hospitalization ($34,180 vs $29186). CONCLUSION: Patient with obesity seem to have a lower likelihood of mortality and biliary causes of pancreatitis. Further, larger epidemiologic studies are needed for further elucidate the exact cause of this finding.

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