Key result
30-day readmissions for HTG-induced acute pancreatitis are linked to ~155% higher inpatient mortality versus index admissions.
Why the study?
Hypertriglyceridemia is an established cause of acute pancreatitis causing substantial morbidity, mortality, and healthcare burden, but data on readmissions were needed.
Observational (n=43,094)
Yes
Odds Ratio: 2.55 (95% CI 1.83–3.57)
Absolute Event Rate: 1.7% vs 0.7%
p-value: p=< 0.001
30-day readmissions for hypertriglyceridemia-induced acute pancreatitis occur in 13.5% of patients and are associated with significantly higher mortality, length of stay, and healthcare costs compared to index admissions.
HTG-AP 30-day readmissions associate with higher mortality and costs; leaves open whether addressing identified predictors improves outcomes.
Background: Hypertriglyceridemia (HTG) is a well-established cause of acute pancreatitis often leading to significant morbidity, mortality, and healthcare burden. This study aimed to describe the rate, reasons, and predictors of HTG-induced acute pancreatitis (HTG-AP) in the USA. Methods: This retrospective study analyzed the Nationwide Readmissions Database (NRD) for 2018 to determine all adults (≥ 18 years) readmitted within 30 days of an index hospitalization of HTG-AP. Hospitalization characteristics and adverse outcomes for 30-day readmissions were highlighted and compared with index admissions of HTG-AP. Furthermore, independent predictors for 30-day readmissions of HTG-AP were also identified. P values ≤ 0.05 were considered statistically significant. Results: In 2018, the rate of 30-day readmission of HTG-AP was noted to be 13.5%. At the time of readmission, AP (45.2%) was identified as the most common principal diagnosis, followed by chronic pancreatitis (6.3%) and unspecified sepsis (4.8%). Compared to index admissions, 30-day readmissions of HTG-AP had a higher proportion of patients with Charlson Comorbidity Index (CCI) scores ≥ 3 (48.5% vs. 33.8%, P < 0.001). Furthermore, we noted higher rates of inpatient mortality (1.7% vs. 0.7%, odds ratio (OR): 2.55, 95% confidence interval (CI): 1.83 - 3.57, P < 0.001), mean length of stay (LOS) (5.6 vs. 4.1 days, OR: 1.5, 95% CI: 1.2 - 1.7, P < 0.001), and mean total healthcare charge (THC) ($56,799 vs. $36,078, OR: 18,702, 95% CI: 15,136 - 22,267, P < 0.001) for 30-day readmissions of HTG-AP compared to index admissions. Independent predictors for 30-day all-cause readmissions of HTG-AP included hypertension, protein energy malnutrition (PEM), CCI scores ≥ 3, chronic kidney disease and discharge against medical advice. Conclusions: AP was the principal diagnosis on presentation in only 45.2% patients for 30-day readmissions of HTG-AP. Compared to index admissions, 30-day readmissions of HTG-AP had a higher comorbidity burden, inpatient mortality, mean LOS and mean THC.
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Kichloo et al. (2022) conducted an observational in Hypertriglyceridemia-induced acute pancreatitis (HTG-AP) (n=43,094). 30-day readmission for hypertriglyceridemia-induced acute pancreatitis vs. Index admission was evaluated on Inpatient mortality (OR 2.55, 95% CI 1.83 - 3.57, p=< 0.001). Thirty-day readmissions for hypertriglyceridemia-induced acute pancreatitis were associated with significantly higher inpatient mortality (1.7% vs 0.7%, OR 2.55) compared to index admissions.
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