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Early discharge of patients with mild acute pancreatitis - A scoping review
Niels Kant1, Astrid Beij2, Robert C Verdonk3
1Clinical Research Center, Rijnstate Hospital, Wagnerlaan 55, 6815 AD, Arnhem, the Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, Faculty of Behavioral, Management and Social Sciences, University of Twente, Hallenweg 5, 7522 NH, Enschede, the Netherlands.
Background:
Acute pancreatitis is a common disease that is usually mild and self-limiting. Early discharge of patients with mild acute pancreatitis, with the use of supporting outpatient services including remote monitoring or smartphone applications, might be safe and could reduce the healthcare demand. The objective of this review was to provide a comprehensive overview of existing strategies aimed at facilitating early discharge of patients diagnosed with mild acute pancreatitis and to assess clinical outcomes, feasibility and costs associated with these strategies.
Methods:
PubMed, Cochrane, Embase, and Web of Science were systematically searched, to identify studies that evaluated strategies to reduce the length of hospital stay in patients with mild acute pancreatitis.
Results:
Five studies, including 84 to 419 patients each, were identified and described three different early discharge protocols. The early discharge strategies resulted in a median length of hospital stay of a minimum of 6 to a maximum of 23 h in these studies. Early discharge compared to usual care did not result in increased 30-day readmissions. Additionally, no occurrences of complications or mortality were observed in either group. A significant reduction in overall costs was reported ranging from 43.1 % to 85.4 %.
Conclusions:
Early discharge of patients with mild acute pancreatitis seems both feasible and safe. Further studies are warranted, since focus on safe early discharge could significantly reduce inpatient healthcare utilization and associated costs.
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