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Hospital Trends of Acute Pancreatitis During the Coronavirus Disease 2019 Pandemic
Mitchell L Ramsey1, Arsheya Patel1, Lindsay A Sobotka1
1From the Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center.
Insights
The COVID-19 pandemic saw fewer acute pancreatitis hospitalizations, but those admitted had more severe outcomes like organ failure. Future care may benefit from pandemic-driven changes in hospitalization and hospital management.
Area of Science:
- Gastroenterology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly altered societal behaviors and healthcare access.
- These changes may have impacted the incidence and severity of various medical conditions, including acute pancreatitis.
Purpose of the Study:
- To investigate the effect of the COVID-19 pandemic on the rates and clinical course of acute pancreatitis (AP).
Main Methods:
- Retrospective review of hospitalizations for AP between March 1 and August 31 in 2019 (pre-pandemic) and 2020 (pandemic).
- Univariate and multivariate analyses were employed to compare demographics and clinical outcomes between the two periods.
Main Results:
- Fewer AP hospitalizations occurred during the pandemic (264 admissions in 2020 vs. 315 in 2019).
- Pandemic group patients showed higher rates of systemic inflammatory response syndrome (40% vs. 25%), pancreatic necrosis (14% vs. 10%), and persistent organ failure (17% vs. 9%).
- Multivariable analysis identified comorbidities, prior pancreatitis, pancreatic necrosis, and opiate prescription as predictors of 30-day readmissions during the pandemic.
Conclusions:
- Reduced hospitalizations during the pandemic may indicate that patients with milder AP symptoms avoided seeking care.
- Pandemic-induced changes, such as reduced hospitalizations and enhanced hospital management efficiency, could offer valuable strategies for future pancreatitis care optimization.
Objective:
The coronavirus disease 2019 pandemic led to changes in individuals' behaviors and healthcare delivery. We examined the impact of these changes on the rates and clinical course of acute pancreatitis (AP).
Methods:
Hospitalizations for AP from March 1 through August 31 in 2019 (baseline group) and the same period in 2020 (pandemic group) were retrospectively reviewed. Univariate and multivariate analyses were used for demographics and outcomes.
Results:
Two hundred eighty subjects (315 admissions) were identified in 2019 and 237 subjects (264 admissions) in 2020. Subjects in the pandemic group were more likely to have systemic inflammatory response syndrome (40% vs 25%, P < 0.01), pancreatic necrosis (14% vs 10%, P = 0.03), and persistent organ failure (17% vs 9%, P = 0.01) compared with prepandemic. There was no difference in etiology of AP. A multivariable model indicates that increased comorbidities, prior pancreatitis, pancreatic necrosis, and prescription of opiates at discharge were associated with 30-day readmissions during the pandemic.
Conclusions:
Fewer patients were admitted for AP during the pandemic, suggesting that patients with milder symptoms avoided hospital interaction. Practices followed during the pandemic, especially avoidance of hospitalization and improved efficiency of hospital management, may reduce the burden of pancreatitis care in the future.
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