S3072 In-hospital Outcomes of Acute Pancreatitis in Patients With Liver Cirrhosis

Abstract

INTRODUCTION: Acute pancreatitis (AP) is the most common disease of the gastrointestinal (GI) tract. Acute pancreatitis was noted to be the most common GI discharge with reported increased incidence in hospitalized patients. The estimated cost of hospitalization for AP was estimated at a cost of 2.6 billion dollars in 2009. A recent study of the NIS database revealed worse outcomes of AP in patients with liver cirrhosis between 2003 and 2013. We conducted this study to evaluate any changes in the outcomes of AP in hospitalized patients with liver cirrhosis between 2012 and 2015. METHODS: The study was derived from the National Inpatient Sample (NIS) database. We queried the database for hospitalization with a primary diagnosis of acute pancreatitis using the International Classification of Diseases, 9th revision, Clinical Modification code 577.0. The primary outcomes were in-hospital mortality and length of stay. We compared the outcomes between patients with and without history of liver cirrhosis/obesity. RESULTS: A total of 1,402,750 were included in the study after exclusion of patients under 18 years of age and those with a history of chronic pancreatitis. 62,110 (4.4%) had a documented history of liver cirrhosis. Overall, patients with liver cirrhosis had significant multiple co-morbidities as compared to those without liver cirrhosis. The in-hospital mortality (adjusted odds ratio: 3.1, 95% confidence interval 2.85 – 3.37, P < 0.001), length of stay and cost of hospitalization were significantly higher in patients with liver cirrhosis. CONCLUSION: Patients with AP and liver cirrhosis have significantly higher mortality, prolonged hospitalization, and healthcare expenditure. The study findings remain similar to a recently published study looking at mortality for patients admitted between 2003 and 2013. It is unclear if the increased mortality is related to complications related to severe forms of acute pancreatitis or liver cirrhosis.Table 1.: Baseline Characteristics of AP index hospitalizationsTable 2.: Adjusted Outcomes of AP admissions with liver cirrhosis (adjusted for age, gender and co-morbidities; obesity, congestive heart failure, hypertension, diabetes mellitus, metastatic cancer, immunodeficiency, alcohol abuse, renal failure and chronic lung disease)