Impact of comorbidities on hospital mortality in patients with acute pancreatitis: a population-based study of 110,021 patients.
Acute pancreatitis
Charlson index
Comorbidity
Elixhauser index
Hospital mortality
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
23 Mar 2023
23 Mar 2023
Historique:
received:
20
09
2022
accepted:
16
03
2023
entrez:
23
3
2023
pubmed:
24
3
2023
medline:
25
3
2023
Statut:
epublish
Résumé
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. 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. 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. 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 36949385
doi: 10.1186/s12876-023-02730-6
pii: 10.1186/s12876-023-02730-6
pmc: PMC10035222
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
81Informations de copyright
© 2023. The Author(s).
Références
J Gerontol A Biol Sci Med Sci. 1999 Feb;54(2):M55-8
pubmed: 10051855
Pancreatology. 2011;11(5):525-32
pubmed: 22094886
Int J Health Sci (Qassim). 2015 Jan;9(1):35-9
pubmed: 25901131
Pancreas. 2014 Jul;43(5):687-91
pubmed: 24694835
Pancreatology. 2018 Jul;18(5):486-493
pubmed: 29802078
Clin Orthop Relat Res. 2014 Sep;472(9):2878-86
pubmed: 24867450
Pancreatology. 2006;6(3):206-9
pubmed: 16549939
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
Pancreas. 2008 Jul;37(1):13-2
pubmed: 18580438
Sci Rep. 2020 Oct 21;10(1):17936
pubmed: 33087766
Lancet. 1989 Jul 22;2(8656):201-5
pubmed: 2568529
Ann Intern Med. 2021 Feb;174(2):ITC17-ITC32
pubmed: 33556276
Gut. 2013 Jan;62(1):102-11
pubmed: 23100216
J Gastroenterol Hepatol. 2017 Feb;32(2):439-445
pubmed: 27356212
Med Care. 2009 Jun;47(6):626-33
pubmed: 19433995
Hernia. 2021 Oct;25(5):1345-1354
pubmed: 33837883
J Clin Gastroenterol. 2000 Jun;30(4):343-56
pubmed: 10875461
Pancreatology. 2009;9(5):601-14
pubmed: 19657215
Rev Esp Cardiol. 2008 Aug;61(8):843-52
pubmed: 18684367
Z Gastroenterol. 2016 Mar;54(3):226-30
pubmed: 27043885
Pancreas. 2006 Nov;33(4):323-30
pubmed: 17079934
Pancreas. 2018 Sep;47(8):917-923
pubmed: 30113426
J Hepatol. 2015 Nov;63(5):1272-84
pubmed: 26192220
Crit Care Med. 2009 Mar;37(3):1018-23
pubmed: 19237912
Gut. 2017 Nov;66(11):2024-2032
pubmed: 28838972
Radiology. 1990 Feb;174(2):331-6
pubmed: 2296641
J Clin Epidemiol. 2012 Jan;65(1):107-15
pubmed: 21803545
Pancreatology. 2008;8(3):265-70
pubmed: 18497539
J Dig Dis. 2021 Jan;22(1):41-48
pubmed: 33184988
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Gastroenterology. 2010 Sep;139(3):813-20
pubmed: 20540942
Pancreas. 2002 Apr;24(3):223-7
pubmed: 11893928
Surg Clin North Am. 1981 Aug;61(4):923-38
pubmed: 7025301
Am J Gastroenterol. 1974 Jun;61(6):443-51
pubmed: 4835417
Gastroenterology. 2019 Jan;156(1):254-272.e11
pubmed: 30315778
Nephrol Dial Transplant. 2008 Apr;23(4):1401-5
pubmed: 18065830
J Gastrointest Surg. 2007 Jun;11(6):733-42
pubmed: 17417710
Pancreas. 2011 Oct;40(7):1018-23
pubmed: 21926541
J Rheumatol. 2004 Apr;31(4):707-12
pubmed: 15088295
Clin Transl Gastroenterol. 2018 Oct 4;9(10):191
pubmed: 30287807
Ann Fam Med. 2003 May-Jun;1(1):8-14
pubmed: 15043174
Epidemiology. 2023 Jan 1;34(1):33-37
pubmed: 36007092
Gastrointest Endosc. 2015 Jan;81(1):143-149.e9
pubmed: 25088919
Med Care. 2005 Nov;43(11):1130-9
pubmed: 16224307
Free Radic Biol Med. 2011 Jan 15;50(2):371-80
pubmed: 21092756
Pancreas. 2013 Nov;42(8):1245-50
pubmed: 24152950
N Engl J Med. 2016 Nov 17;375(20):1972-1981
pubmed: 27959604
Eur Heart J. 2006 Jan;27(1):65-75
pubmed: 16219658
J Clin Gastroenterol. 2005 Oct;39(9):798-814
pubmed: 16145344
PLoS One. 2014 Dec 09;9(12):e114866
pubmed: 25490399
JGH Open. 2019 Mar 26;3(4):338-343
pubmed: 31406928
Am Fam Physician. 2006 Nov 1;74(9):1537-44
pubmed: 17111893
Respir Med. 2018 May;138:137-143
pubmed: 29724386
Pediatrics. 2016 Sep;138(3):
pubmed: 27535145
Pancreas. 2012 Jul;41(5):696-702
pubmed: 22699142
Am J Gastroenterol. 2010 Feb;105(2):435-41; quiz 442
pubmed: 19861954
Scand J Public Health. 2020 Feb;48(1):14-19
pubmed: 29722597
World J Gastroenterol. 2009 Jun 28;15(24):2945-59
pubmed: 19554647
Gut Liver. 2011 Sep;5(3):335-9
pubmed: 21927663
World J Gastroenterol. 2008 Apr 28;14(16):2517-21
pubmed: 18442198
Can J Gastroenterol Hepatol. 2021 Mar 22;2021:6643595
pubmed: 33824864
Arch Intern Med. 2002 Nov 11;162(20):2269-76
pubmed: 12418941
Med Care. 1998 Jan;36(1):8-27
pubmed: 9431328
Hepatobiliary Pancreat Dis Int. 2015 Aug;14(4):422-8
pubmed: 26256088
Eur J Gastroenterol Hepatol. 2011 Nov;23(12):1136-43
pubmed: 21904207
Pancreas. 2008 May;36(4):432-4
pubmed: 18437092
Surg Gynecol Obstet. 1974 Jul;139(1):69-81
pubmed: 4834279
J Clin Gastroenterol. 2018 Feb;52(2):178-183
pubmed: 28009683
Gut. 2008 Dec;57(12):1698-703
pubmed: 18519429
United European Gastroenterol J. 2018 Dec;6(10):1508-1518
pubmed: 30574321