Tu1504 Non-Occlusive Mesenteric Ischemia Diagnosed by Angiography at the Beginning of Continuous Regional Arterial Infusion Therapy is a Strong Predictive Factor for Mortality Due to Severe Acute Pancreatitis

Abstract

BACKGROUND: Pancreatic pseudocyts related hospitalizations are increasing in prevalence. However, risk factors for the development of pancreatic pseudo cysts are not well understood. METHODS: We used data from Nationwide Inpatient Sample from years 2005 2008 to perform a cross sectional study of the patients hospitalized for pancreatic pseudocysts (PP) as identified by appropriate International Classification of Diseases, Ninth Revision (ICD9) discharge diagnoses codes. The patients were then categorized into two groups those with concomitant diagnosis of acute pancreatitis (AP) and chronic pancreatitis (CP) as identified by ICD9 diagnosis codes. The demographic characteristics, clinical characteristics and the risk factors for development of PP for the two groupswere studied. Univariate andMultivariate logistic regression methods using STATA 12.0 survey commands were used to compare the risk factors for development of pancreatic pseudocyst among the two groups adjusting for clinically important covariates such as age, gender, hypovolemia, acute renal failure, ascites, pancreatic necrosis, deyo-charlson comorbidity index. RESULTS: Of a total of 144558 patients hospitalized for PP, 66882 (46.2%) had AP and 36535 (25.3%) had CP. Mean age of the population is 57 years, mean length of stay 9.5 days, mean total charges $52914. There were a higher number of males (53.9%) in the population. Multivariate analyses adjusting for age, gender, comorbidities, ascites, hypovolemia, acute renal failure (ARF) revealed that among patients with acute pancreatitis ,patients who had ARF( adjusted odds ratio, (aOR) 1.30 (1.13-1.50), hypovolemia (aOR 1.18 (1.13-1.24), ascites (aOR 3.06 (2.163.40), (p <0.001) had a higher odds for PP formation. Among CP patients, patients who had pancreatic necrosis (aOR, 2.24, (2.10-2.30), ascites (aOR, 2.58, (2.15-3.05), (p <0.001) were significantly associated with formation of PP. In the multivariate analysis, female gender seemed to be associated with lower odds for development of PP in both AP(aOR ,0.61,(0.580.63) and CP (aOR,0.65,(0.61-0.69) patients. CONCLUSIONS: Ascites, male sex, pancreatic necrosis, hypovolemia, acute renal failure are risk factors for development of pancreatic pseudocyst.