Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample Database
Pancreatitis usually presents with characteristic abdominal pain, radiological findings, and elevated lipase. The presence of jaundice may hint at a biliary etiology; however, it is not always present. We hypothesized that the presence of jaundice is associated with worse outcomes in patients admitt...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2022/5048061 |
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| author | Nishit Patel Krishna Bodrya Kirten Patel Nishi Patel Dhruvanshu Patel Ronak Modi Ayaz Matin |
| author_facet | Nishit Patel Krishna Bodrya Kirten Patel Nishi Patel Dhruvanshu Patel Ronak Modi Ayaz Matin |
| author_sort | Nishit Patel |
| collection | DOAJ |
| description | Pancreatitis usually presents with characteristic abdominal pain, radiological findings, and elevated lipase. The presence of jaundice may hint at a biliary etiology; however, it is not always present. We hypothesized that the presence of jaundice is associated with worse outcomes in patients admitted with pancreatitis. We conducted a retrospective analysis using the National Inpatient Sample, inquiring about patients admitted with pancreatitis with and without jaundice between October 2015 and December 2017. The primary outcome was in-hospital mortality in patients admitted for pancreatitis with and without jaundice. Secondary outcomes were the median length of stay, hospitalization cost, the incidence of ventilator-dependent respiratory failure (VDRF), acute respiratory distress syndrome (ARDS), sepsis, septic shock, dehydration and electrolyte disturbances, and ascites. A total of 1,267,744 patients were admitted with pancreatitis from October 2015 to December 2017. Among them, 8855 (0.7%) had concomitant jaundice on presentation. In-hospital mortality in this group was 4.3%. The patients with pancreatitis and jaundice had higher odds of in-hospital mortality (adjusted odds ratio [aOR]: 1.51, 99% CI 1.35–1.68, p<0.0001) as compared to those without jaundice. Patients with jaundice showed a significantly higher incidence of sepsis (15.2% vs. 9.6%, p<0.0001), septic shock (4.1% vs. 2.9%, p<0.0001), ascites (6.5% vs. 3.1%, p<0.0001), and dehydration and electrolyte disorders (47.6% vs. 43.8%, p<0.0001). Patients with jaundice also had higher total hospital costs ($11,412 vs. $7893, p<0.0001). There was no statistical difference in ARDS, VDRF, and median length of stay. In conclusion, patients admitted for pancreatitis with jaundice had worse outcomes, including in-hospital mortality and complications, compared to those without jaundice. |
| format | Article |
| id | doaj-art-70666e08ce7b4467a570f915eca60695 |
| institution | Kabale University |
| issn | 1687-630X |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-70666e08ce7b4467a570f915eca606952025-02-03T01:07:56ZengWileyGastroenterology Research and Practice1687-630X2022-01-01202210.1155/2022/5048061Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample DatabaseNishit Patel0Krishna Bodrya1Kirten Patel2Nishi Patel3Dhruvanshu Patel4Ronak Modi5Ayaz Matin6Internal Medicine DepartmentTrumbull Regional Medical CenterSt. Mary Mercy HospitalUniversity of South Columbia (Pharmacy)Internal Medicine DepartmentGastroenterology DepartmentGastroenterology DepartmentPancreatitis usually presents with characteristic abdominal pain, radiological findings, and elevated lipase. The presence of jaundice may hint at a biliary etiology; however, it is not always present. We hypothesized that the presence of jaundice is associated with worse outcomes in patients admitted with pancreatitis. We conducted a retrospective analysis using the National Inpatient Sample, inquiring about patients admitted with pancreatitis with and without jaundice between October 2015 and December 2017. The primary outcome was in-hospital mortality in patients admitted for pancreatitis with and without jaundice. Secondary outcomes were the median length of stay, hospitalization cost, the incidence of ventilator-dependent respiratory failure (VDRF), acute respiratory distress syndrome (ARDS), sepsis, septic shock, dehydration and electrolyte disturbances, and ascites. A total of 1,267,744 patients were admitted with pancreatitis from October 2015 to December 2017. Among them, 8855 (0.7%) had concomitant jaundice on presentation. In-hospital mortality in this group was 4.3%. The patients with pancreatitis and jaundice had higher odds of in-hospital mortality (adjusted odds ratio [aOR]: 1.51, 99% CI 1.35–1.68, p<0.0001) as compared to those without jaundice. Patients with jaundice showed a significantly higher incidence of sepsis (15.2% vs. 9.6%, p<0.0001), septic shock (4.1% vs. 2.9%, p<0.0001), ascites (6.5% vs. 3.1%, p<0.0001), and dehydration and electrolyte disorders (47.6% vs. 43.8%, p<0.0001). Patients with jaundice also had higher total hospital costs ($11,412 vs. $7893, p<0.0001). There was no statistical difference in ARDS, VDRF, and median length of stay. In conclusion, patients admitted for pancreatitis with jaundice had worse outcomes, including in-hospital mortality and complications, compared to those without jaundice.http://dx.doi.org/10.1155/2022/5048061 |
| spellingShingle | Nishit Patel Krishna Bodrya Kirten Patel Nishi Patel Dhruvanshu Patel Ronak Modi Ayaz Matin Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample Database Gastroenterology Research and Practice |
| title | Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample Database |
| title_full | Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample Database |
| title_fullStr | Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample Database |
| title_full_unstemmed | Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample Database |
| title_short | Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample Database |
| title_sort | jaundice on presentation is associated with higher in patient mortality and complications in patients admitted for acute pancreatitis a retrospective study based on national inpatient sample database |
| url | http://dx.doi.org/10.1155/2022/5048061 |
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