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Outcomes of Acute Pancreatitis Hospitalizations with Obesity
Neelam Khetpal1, Mohamad Sharbatji2, Mohammad Maysara Asfari3
1Hartford HealthCare Medical Group at Hartford Hospital, Department of Hospital Medicine, Hartford, CT, 06102, USA.
Insights
Obese and overweight individuals hospitalized for acute pancreatitis (AP) have similar inpatient mortality rates compared to normal weight patients. However, obesity is linked to increased complications and healthcare utilization in AP hospitalizations.
Area of Science:
- Medical research
- Clinical outcomes
- Public health
Background:
- Body Mass Index (BMI) is a critical factor in various health conditions.
- Acute pancreatitis (AP) is a significant cause of hospitalization with varying risk factors.
- Understanding the impact of BMI on AP hospitalizations is crucial for patient management and resource allocation.
Purpose of the Study:
- To assess the relationship between body mass index (BMI) and acute pancreatitis (AP) hospitalizations in the United States.
- To compare hospitalization characteristics and outcomes across different BMI categories (normal weight, overweight, obese).
Main Methods:
- Utilized the National Inpatient Sample database for 2020 AP hospitalizations in the US.
- Categorized patients into normal weight, overweight, and obese based on BMI.
- Compared patient demographics, hospitalization characteristics, and clinical outcomes.
Main Results:
- In 2020, 20% of AP hospitalizations were in obese patients (n=53,000), 2.6% in overweight (n=3980), and 77.4% in normal weight (n=210,000).
- All-cause inpatient mortality was similar across BMI groups (0.65% obese vs. 0.63% overweight vs. 0.6% normal weight).
- Obese patients had higher odds of systemic complications (OR: 1.7) and requiring intubation or vasopressors (OR: 1.75). Overweight patients showed increased jejunostomy tube use (OR: 1.74).
- Obese AP hospitalizations incurred higher healthcare costs (+$21,626) and longer stays (+2.14 days) compared to normal weight patients.
Conclusions:
- Obesity and overweight status do not significantly increase inpatient mortality for acute pancreatitis.
- Obese patients with AP experience a higher incidence of complications and greater healthcare resource utilization.
- These findings highlight the importance of weight management in mitigating AP severity and healthcare burden.
Objective:
Assessing the relationship of body mass index (BMI) on acute pancreatitis (AP) hospitalization in the United States (US).
Methods:
The National Inpatient Sample utilized to capture normal weight, overweight, and obese AP hospitalization in the US during 2020 based on BMI. Patients, hospitalization characteristics, and outcomes were compared.
Results:
In 2020, there were 53,000 (20%) obese, 3980 (2.6%) overweight, and 210,000 (77.4%) normal weight AP hospitalizations. All-cause inpatient mortality was similar for obese, and overweight compared to normal weight AP hospitalizations, respectively (0.65% vs 0.63% vs 0.6%). Furthermore, obese AP hospitalization had a higher chance of developing systemic [odds ratio (OR): 1.7, confidence interval (CI) (1.35-2.12)], and needing intubation or vasopressor requirement OR: 1.75, CI (1.14-2.68), compared to normal AP patients. However, overweight AP hospitalizations had similar chance of developing systemic OR: 1.1, CI (0.83-1.38) and local complication OR: 1.14, CI (0.88-1.5), needing intubation or vasopressor requirements OR: 1.27, CI (0.73-2.23) except use of jejunostomy tube was higher OR: 1.74, CI (1.1-2.75) compared to normal weight AP hospitalizations. The mean length-of-stay and mean total healthcare costs were higher among obese by 2.14 days (CI 0.9-3.37), p = 0.001 and by US$ 21,626, CI (4379-38,872), p = 0.014 compared to normal weight AP hospitalizations.
Conclusions:
Obese and overnight AP hospitalizations had similar inpatient mortality compared to normal weight hospitalizations. Obese AP hospitalizations have higher complications and healthcare utilization compared to normal weight hospitalizations.
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