Impact of comorbidities on hospital mortality in patients with acute pancreatitis : a population-based study of 110,021 patients
Hidalgo, Nils Jimmy (Hospital Universitari Vall d'Hebron)
Pando, Elizabeth (Hospital Universitari Vall d'Hebron)
Mata, Rodrigo (Hospital Universitari Vall d'Hebron)
Fernandes, Nair (Hospital Universitari Vall d'Hebron)
Villasante, Sara (Hospital Universitari Vall d'Hebron)
Barros, Marta (Hospital Universitari Vall d'Hebron)
Herms, Daniel (Hospital Universitari Vall d'Hebron)
Blanco, Laia (Hospital Universitari Vall d'Hebron)
Balsells Valls, Joaquim (Hospital Universitari Vall d'Hebron)
Charco, Ramon (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	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. The online version contains supplementary material available at 10. 1186/s12876-023-02730-6.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Acute pancreatitis ; Charlson index ; Comorbidity ; Elixhauser index ; Hospital mortality
Published in:	BMC Gastroenterology, Vol. 23 (march 2023) , ISSN 1471-230X

DOI: 10.1186/s12876-023-02730-6
PMID: 36949385

10 p, 1.3 MB

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