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. 2023 Mar 23;23(1):81.
doi: 10.1186/s12876-023-02730-6.

Impact of comorbidities on hospital mortality in patients with acute pancreatitis: a population-based study of 110,021 patients

Nils Jimmy Hidalgo  1   2 , Elizabeth Pando  3   4 , Rodrigo Mata  2 , Nair Fernandes  2 , Sara Villasante  2 , Marta Barros  2 , Daniel Herms  2 , Laia Blanco  2 , Joaquim Balsells  2 , Ramon Charco  2
Affiliations

Impact of comorbidities on hospital mortality in patients with acute pancreatitis: a population-based study of 110,021 patients

Nils Jimmy Hidalgo et al. BMC Gastroenterol. .

Abstract

Background: The impact of pre-existing comorbidities on acute pancreatitis (AP) mortality is not clearly defined. Our study aims to determine the trend in AP hospital mortality and the role of comorbidities as a predictor of hospital mortality.

Methods: We analyzed patients aged ≥ 18 years hospitalized with AP diagnosis between 2016 and 2019. The data have been extracted from the Spanish National Hospital Discharge Database of the Spanish Ministry of Health. We performed a univariate and multivariable analysis of the association of age, sex, and comorbidities with hospital mortality in patients with AP. The role of the Charlson and Elixhauser comorbidity indices as predictors of mortality was evaluated.

Results: A total of 110,021 patients diagnosed with AP were hospitalized during the analyzed period. Hospital mortality was 3.8%, with a progressive decrease observed in the years evaluated. In multivariable analysis, age ≥ 65 years (OR: 4.11, p < 0.001), heart disease (OR: 1.73, p < 0.001), renal disease (OR: 1.99, p < 0.001), moderate-severe liver disease (OR: 2.86, p < 0.001), peripheral vascular disease (OR: 1.43, p < 0.001), and cerebrovascular disease (OR: 1.63, p < 0.001) were independent risk factors for mortality. The Charlson > 1.5 (OR: 2.03, p < 0.001) and Elixhauser > 1.5 (OR: 2.71, p < 0.001) comorbidity indices were also independently associated with mortality, and ROC curve analysis showed that they are useful for predicting hospital mortality.

Conclusions: Advanced age, heart disease, renal disease, moderate-severe liver disease, peripheral vascular disease, and cerebrovascular disease before admission were independently associated with hospital mortality. The Charlson and Elixhauser comorbidity indices are useful for predicting hospital mortality in AP patients.

Keywords: Acute pancreatitis; Charlson index; Comorbidity; Elixhauser index; Hospital mortality.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Case Selection Flow Chart. AP: acute pancreatitis IDC-10: 10th revision of the International Statistical Classification of Diseases
Fig. 2
Fig. 2
ROC curve and AUC (Area Under the Curve) of the Charlson Comorbidity Index, and the Elixhauser Comorbidity Index in predicting the hospital mortality rate in patients with acute pancreatitis
See this image and copyright information in PMC

References

    1. Peery AF, Crockett SD, Murphy CC, Lund JL, Dellon ES, Williams JL, et al. Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: Update 2018. Gastroenterology. 2019;156:254–272.e11. doi: 10.1053/j.gastro.2018.08.063. - DOI - PMC - PubMed
    1. Forsmark CE, Vege SS, Wilcox CM. Acute Pancreatitis. N Engl J Med. 2016;375:1972–1981. doi: 10.1056/NEJMra1505202. - DOI - PubMed
    1. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, et al. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–111. doi: 10.1136/gutjnl-2012-302779. - DOI - PubMed
    1. Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: a systematic review. Pancreas. 2006;33:323–330. doi: 10.1097/01.mpa.0000236733.31617.52. - DOI - PubMed
    1. Shen H-N, Lu C-L, Li C-Y. Epidemiology of first-attack acute pancreatitis in Taiwan from 2000 through 2009: a nationwide population-based study. Pancreas. 2012;41:696–702. doi: 10.1097/MPA.0b013e31823db941. - DOI - PubMed