S0089 Acute Pancreatitis and Metabolic Syndrome: Prevalence, Trends, and Outcomes

Abstract

INTRODUCTION: With the rising prevalence of obesity and diabetes prevalence of metabolic syndrome (MetS) is on the rise. Data on the association between acute pancreatitis (AP) and MetS are limited. We aimed to assess the prevalence, trends, outcomes and outcomes of AP in patients with MetS. METHODS: Using ICD-9 codes all patients with the diagnosis of AP between 2005 and 2014 were identified from National Inpatient Sample (NIS) database. MetS was defined as the presence of 3/4 of diabetes, obesity, HTN and hyperlipidemia. Demographics, prevalence and mortality trends were assessed for patients with AP and MetS. A multivariate analysis was done to assess differences in acute kidney injury (AKI), systemic inflammatory response syndrome (SIRS), shock, portal vein thrombosis (PVT), mechanical ventilation (MV), cost of hospitalization, and length of stay (LOS) amongst AP patients with and without MetS. RESULTS: A total of 345,444 patients were admitted between 2005 and 2014 with the diagnosis of AP and MetS. The prevalence of patients admitted with AP and MetS has doubled in the last decade (8.2 % vs. 16.4%, P < 0.01) (Figure 1). There has also been a slight but significant uptrend in mortality P < 0.01) (Figure 2). Compared to AP patient with MetS, AP patients without Mets were younger in age (56.9 vs. 50.7 years), had more females (44.8 vs. 48.6%) and had higher percentage of Caucasians (65.5 vs. 62.5%) but lesser AA (17.6 vs. 16.4%) and Hispanics (13.9 vs. 12.6%) (P < 0.001) for all). They also had significantly lower Charleston Co-morbidity index (CCI) (1.77 vs. 0.76, P < 0.001). After adjusting for age, gender, race, alcohol use and CCI, the odds of AKI, SIRS and shock were significantly higher in AP patients with Mets than without (adjusted odds ratio [aOR]: 1.26, 1.68 and 1.08, respectively, P < 0.01 for all). But, presence of MetS was associated with lesser mortality, MV, and PVT in AP patients than without MetS (aOR: 0.49, 0.89, and 0.79, respectively, P < 0.001 for all). The overall cost of hospitalization and LOS were significantly higher amongst AP patients with MetS than without MetS ($34112 vs. $31085 and 5.12 vs. 5.07 days, respectively, P < 0.01 for both). CONCLUSION: Our study suggests that the prevalence of hospitalized AP patients with MetS has doubled in the last decade with an increase in mortality trend. Presence of MetS in patients with AP is associated with higher odds of AKI, SIRS and shock, and leads to significant increase in cost of hospitalization and LOS.Figure 1.: Trend of Acute Pancreatitis with Metabolic Syndrome.Figure 2.: Mortality Trend of Acute Pancreatitis with Metabolic Syndrome.