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Thirty-Day Readmission Predicts 1-Year Mortality in Acute Pancreatitis
Peter J W Lee1, Amit Bhatt, Rocio Lopez
1From the Digestive Disease Institute and Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.
Insights
Predicting mortality after acute pancreatitis (AP) is crucial. Early readmission within 30 days significantly increases the risk of death within a year for AP patients.
Area of Science:
- Gastroenterology
- Clinical Medicine
- Epidemiology
Background:
- Prognostic indicators for patients discharged after acute pancreatitis (AP) are not well-established.
- Identifying risk factors for post-discharge mortality is essential for improving patient outcomes.
Purpose of the Study:
- To identify key risk factors associated with mortality in patients following hospital discharge for acute pancreatitis.
Main Methods:
- A retrospective cohort study analyzed data from 331 patients admitted with AP between 2007 and 2011.
- Cox regression models were used to assess variables linked to mortality within one year of discharge.
Main Results:
- 12.4% of patients died after discharge, with 10.0% dying within one year.
- Higher Charlson Comorbidity Index, elevated blood urea nitrogen, higher Bedside Index of Severity in Acute Pancreatitis scores, longer hospital stays, and 30-day readmission were associated with increased mortality risk.
- Readmission within 30 days was a significant predictor, increasing the hazard of 1-year mortality by 4.5 times.
Conclusions:
- A higher Charlson Comorbidity Index, readmission within 30 days, and prolonged hospitalization are significant predictors of 1-year mortality after acute pancreatitis.
- These factors can help clinicians stratify risk and guide post-discharge care for AP patients.
Objectives:
There is limited knowledge of the prognostic indicators after hospital discharge after acute pancreatitis (AP). The aim was to determine risk factors for mortality after discharge in patients admitted with AP.
Methods:
A retrospective cohort study was conducted, including consecutive patients with AP admitted to the Cleveland Clinic between 2007 and 2011. Clinical data, mortality status, and the date of death were collected. Univariable and multivariable Cox regression was performed to determine variables significantly associated with mortality within a year of discharge.
Results:
Three hundred thirty-one patients were included in the study, current to July 2012. After a mean follow-up of 20 months, 41 subjects (12.4%) died after discharge from the hospital. Thirty-three (10.0%) died within a year after discharge. In univariable analyses, higher Charlson Comorbidity Index, blood urea nitrogen > 20 on admission, higher Bedside Index of Severity in Acute Pancreatitis scores, longer length of stay, and readmission within 30 days were associated with a higher hazard of mortality. In the multivariable analysis, subjects who were readmitted within 30 days had a 4.5 times higher hazard of dying within a year than those who were not readmitted (hazard ratio, 4.5; 95% confidence interval, 2.2-9.1).
Conclusion:
A higher Charlson Comorbidity Index, early readmission, and longer hospitalization predict a higher 1-year mortality after AP.
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