Mo1355 Factors Affecting Cholecystectomy in Acute Gallstone Pancreatitis in a Nationwide Inpatient Sample

Abstract

Background: Age Adjusted Charlson Comorbidity Index (AACCI) has been studied in the past to predict morbidity and mortality in various clinical conditions. At the same time there has been various markers and scores developed to predict morbidity and mortality in acute pancreatitis. Most of the tools used in acute pancreatitis, were unable to reach adequate sensitivity and specificity. However AACCI was never studied in the setting of acute pancreatitis. We hypothesized that AACCI which reflects the influence of burden of comorbid conditions, may predict outcomes in acute pancreatitis. We studied correlation between AACCI and length of hospital stay in individuals admitted with acute pancreatitis.Methods: We conducted retrospective observational study between January 1, 2009 and June 30, 2011 including all individuals admitted to our institutionwith acute pancreatitis.We collected demographic, laboratory, and radiological data. We used Length of Stay (LOS) as a measure of inpatient morbidity and extracted LOS days from medical records. We calculated AACCI based on comorbid conditions noted in electronic medical records. We divided study population into 3 groups based on AACCI score, Group A (scores 0 to 2), Group B (scores 3 to 5) and Group C (score 6 and above). We analyzed data using standard statistical methods and JMP11 software. Results: There were 209 individuals who met the inclusion criteria as per current definition of acute pancreatitis. Men and women were represented equally. There were 51% Hispanics and 49% non-Hispanics of which 80% were African Americans. There were no significant differences in LOS between women and men (10.25 vs. 10.42 days, p 0.91), between Hispanics and non-Hispanics (9.23 vs. 10.82, p 0.28). Also we did not notice any difference in length of stay based on etiology of acute pancreatitis. However we found significant increase in length of stay parallel to increase in AACCI (Table 1). (Group A 8.31, Group B 11.09 and Group C 15.44 days, p 0.002) Conclusion: Increase in Age Adjusted Charlson Comorbidity Index predicted prolonged Length of Stay, in patients hospitalized with acute pancreatitis. Our study is unique in studying relation between AACCI and LOS in acute pancreatitis especially in minority populations. Further studies are needed to relate AACCI with various local and systemic complications in acute pancreatitis, which may give single tool to predict outcomes without elaborative laboratory or radiological work up. Table 1