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Discharge protocol in acute pancreatitis: an international survey and cohort analysis

Rita Nagy1,2,3, Klementina Ocskay3, Zoltán Sipos2

  • 1Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.

Scientific Reports
|December 13, 2023
PubMed

Insights

Developing a discharge protocol for acute pancreatitis (AP) is crucial. The Hungarian Pancreatic Study Group (HPSG) protocol demonstrated shorter hospital stays and low readmission rates, proving its effectiveness and safety for AP patient care.

Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Health Services Research

Background:

  • Existing acute pancreatitis (AP) clinical guidelines lack patient discharge recommendations.
  • The Hungarian Pancreatic Study Group (HPSG) developed a novel discharge protocol based on laboratory data and symptoms.
  • Validation of the HPSG discharge protocol is essential for standardizing AP patient care.

Purpose of the Study:

  • To survey international discharge protocols for acute pancreatitis (AP).
  • To validate the safety and effectiveness of the HPSG-developed discharge protocol.
  • To assess the impact of discharge protocols on hospitalization length and readmission rates.

Main Methods:

  • International survey distributed to members of the International Association of Pancreatology (IAP).
  • Retrospective analysis of patient data to evaluate the HPSG discharge protocol's outcomes.
  • Comparison of length of hospitalization (LOH) and readmission rates between protocol-guided and non-protocol-guided discharges.

Main Results:

  • 87.5% of surveyed centers lacked specific AP discharge protocols.
  • Protocol-guided discharge significantly reduced median length of hospitalization (LOH) (7 days vs. 8 days, p < 0.001).
  • Protocol-guided discharge showed a lower rate of readmission for recurrent AP episodes (p = 0.005).
  • The HPSG protocol achieved the shortest LOH (6 days) with a median CRP of 35.40 mg/l.
  • Readmittance rate was low at 5% (35 patients).

Conclusions:

  • Discharge protocols are necessary for acute pancreatitis (AP) management.
  • The HPSG protocol is the first clinically validated discharge protocol for AP.
  • Further development and testing of AP discharge protocols are needed for standardized patient care.

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