Abstract
Introduction: Protein calorie malnutrition (PCM) is debilitating and highly prevalent condition in patients with chronic pancreatitis. Our aim was to evaluate the impact of PCM on complication rates, in-hospital mortality rate, length of stay, and overall cost in patients hospitalized with ACP. Methods: We used hospitalization data from the nationwide inpatient sample (NIS), the largest all-payer inpatient care database in the United States, to estimate complication rates, in-hospital mortality, length of stay, and hospital charges for all adult admissions related to ACP in 2008. All diagnoses and procedures were identified using ICD-9CM codes. Comorbidities were derived using Quin algorithm for Deyo-Charlson comorbidity scoring scheme. Survey data analysis was performed with appropriate weights and stratum variable. Multivariate risk estimates were obtained after adjusting for demographics, insurance status, burden of comorbidities, alcoholism, HIV, and diabetes.Table 1Results: There were total 32,172 hospital admissions with primary diagnosis of acute pancreatitis in patients with pre-existing history of chronic pancreatitis. There was no significant difference in age, sex, race, median house hold income, and insurance status between PCM and non-PCM patients. Patients with PCM were 2.8 fold for pseudocyst, 2.4 fold for pancreatectomy, 2.2 fold for sepsis, 2.8 fold for ARDS and 2.4 fold for overall complications rate. The PCM was also associated with 83% longer length of stay and 90% higher total charges than patients without PCM. Although not significant, PCM patients were 2.3 folds at greater risk for in-hospital mortality and 2.8 fold for pseudocyst (see table). Conclusion: PCM is associated with higher risk of pancreatic pseudocyst, pancreatectomy, sepsis, ARDS, greater length of hospital stay, and hospital charges in patients with ACP. Patients with known chronic pancreatitis should be evaluated for PCM and undergo optimal nutrition management. Outpatient optimal nutrition management should be emphasized in patients with chronic pancreatitis.
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