High Readmission Rates in Necrotizing Pancreatitis

TOPLINE:

Almost one fifth of patients hospitalized for necrotizing pancreatitis (NP) will be readmitted within 30 days, with biliary and idiopathic pancreatitis carrying higher risk than alcohol-induced disease, according to a new study.

METHODOLOGY:

• NP is associated with a significant healthcare burden, including hospital admission, but few studies have evaluated readmission rates of NP.
• Researchers assessed 30-day readmission rates for NP in the United States using the National Readmission Database.
• A multivariate regression model was used to calculate odds of all-cause 30-day readmission, inpatient mortality, length of stay, and total hospital charge after adjusting for factors including comorbidities, insurance type, and hospital setting. Readmission risks were stratified by NP etiology (biliary, alcohol-induced, idiopathic, and other causes).

TAKEAWAY:

• From 2016-2020, 43,968 index admissions for NP were identified, of which about 18.6% resulted in readmission within 30 days, with a higher proportion of men on index hospitalization and 30-day readmission.
• On readmission, NP was the admitting diagnosis in only 27.6% of patients, followed by pancreatitis without necrosis (17.7%), sepsis (8.8%), and pancreatic pseudocyst (6.9%).
• Biliary and idiopathic pancreatitis had higher 30-day readmission risks (adjusted hazard ratios, 1.46 and 1.45, respectively; P < .001) than alcohol-induced pancreatitis.
• Readmissions had lower inpatient mortality (2% vs 3%), shorter hospital stays (7 vs 11 days), and lower healthcare costs ($75,282 vs $125,480) than index hospital stays.

IN PRACTICE:

“Despite continuous ongoing efforts to establish the best standard of care, NP continues to pose a therapeutic challenge, and a multidisciplinary team approach is essential to minimize readmission rates and associated complications. Clinicians should be vigilant about NP readmission risks, particularly in patients with biliary and idiopathic etiologies. A more structured outpatient follow-up and optimized post-discharge care could reduce unnecessary readmissions,” the researchers concluded.

SOURCE:

The study, with first author Dushyant Singh Dahiya, MD, Division of Gastroenterology, Hepatology & Motility, University of Kansas School of Medicine, Kansas City, Kansas, was published online in the Journal of Clinical Gastroenterology.

LIMITATIONS:

The National Readmission Database lacks information on disease treatment, such as inpatient and outpatient clinical course, procedural management, drug therapy, or laboratory and imaging findings. Coding errors in administrative databases could affect diagnostic accuracy.

DISCLOSURES:

The study had no specific funding. The authors declared no conflicts of interest.

A multivariate regression model was used to calculate odds of all-cause 30-day readmission, inpatient mortality, length of stay, and total hospital charge after adjusting for factors including comorbidities, insurance type, and hospital setting. Readmission risks were stratified by NP etiology (biliary, alcohol-induced, idiopathic, and other causes).