Diario del páncreas Acceso abierto

Abstracto

Predictors of In-Hospital Mortality in Acute Pancreatitis

David Mossad, Brian Dinh, Ronald Markert, Mustafa Musleh, Sangeeta Agrawal

Background and Aims Pancreatitis presents with significant risk for morbidity and mortality acutely. The purpose of this study was to evaluate demographics, comorbidity burden, and hospital characteristics and their effect on in-hospital mortality in patients with acute pancreatitis. Methods Data was collected from The National Hospital Discharge Survey for patients admitted for acute pancreatitis from 2001-2010. Patients were separated into those who suffered in-hospital mortality and those that were discharged. Data was analyzed regarding demographics, length of stay, comorbidity burden, mortality, principal payment, and hospital size. Statistical comparisons were made using SPSS with chi-square and student T tests with a significance level of 0.05. Results 27,259 cases of acute pancreatitis were identified, with 573 who suffered in-hospital mortality. The mortality group was significantly older and had a longer length of stay. Patients with four or more comorbidities had a higher mortality rate (2.5%) compared to those with three or less (0.1%) (p<0.001). Region displayed a difference in mortality, with the Midwest showing a lower rate (1.6%) compared to all other regions. Mortality was lowest in small hospitals. Hospital ownership, however, did not show any significant differences in mortality. There was a difference in mortality rate when comparing principal forms of payment (p<0.001), with Medicare and Medicaid patients having the highest mortality rates. Conclusions Pancreatitis poses significant implications in morbidity and mortality in the acute setting. This study shows that factors such as age, length of stay, comorbidity burden, principal source of payment, and regional demographics have an impact on in-hospital mortality.