Admissions for acute biliary pancreatitis without necrosis and infection complicated by severe sepsis and septic shock: a national study

Abstract

Background: Severe sepsis with septic shock (SSWSS) is a potential and severe complication that can arise among patients hospitalized for acute biliary pancreatitis.

Methods: We queried the 2018-2021 National Inpatient Sample for adults with a primary diagnosis code of acute biliary pancreatitis without necrosis or infection. Baseline characteristics of the patients were studied and multivariate regression models were used to appraise the roles of different factors for events of SSWSS.

Results: We evaluated 136,140 adults who had acute biliary pancreatitis without necrosis or infection on admission; their median age was 57.0 years, and the majority were female (60.6%). Of these, 435 patients developed SSWSS. Higher odds were seen in cases with coexisting chronic kidney disease (P<0.001), liver cirrhosis (P<0.001), and human immunodeficiency virus infection (P<0.001). Races other than White/Black/Hispanics had higher odds (P<0.001) than Whites. Females were less likely to report SSWSS (P<0.001) than males. Moreover, patients from the 26^th-50^th median household quartiles had lower odds of SSWSS than those in the 0-25^th quartiles. Medium (P<0.001) and large (P<0.001) hospitals reported more cases than small hospitals. Admissions in the southern areas of the United States also exhibited higher odds (P=0.026), than Northeast regions. Lower odds were noted in smokers (P<0.001) and cases with dyslipidemia (P=0.048). SSWSS led to higher mortality rates (65.5% vs. 0.4%).

Conclusions: In our nationwide analysis, we found that episodes of SSWSS among patients with acute biliary pancreatitis were influenced by several factors. SSWSS patients also had higher mortality.

Keywords: Acute biliary pancreatitis; United States of America; critical care; severe sepsis.

Figure 1

Selection of patients from the NIS NIS, National Inpatient Sample; SSWS, severe sepsis with septic shock