Healthcare costs of recurrent acute pancreatitis hospitalizations

Patients with severe hypertriglyceridemia (HTG) with hyperchylomicronemia (HC) are at especially high risk for recurrent acute pancreatitis (AP), a leading gastrointestinal cause of hospitalizations.

To describe the real-world frequency, cost, duration, and mortality rates of AP hospitalizations among patients with HC in the United States.

Data were derived from the Healthcare Cost and Utilization Project Nationwide Readmissions Database (2017-2021). Hospitalizations with any diagnostic code for AP were selected. Unadjusted per-person annual AP hospitalizations, costs, duration, and mortality were analyzed for patients with AP, AP+HTG, or AP+HC. Days between AP hospitalizations were calculated for patients with ≥4 hospitalizations. Regression modeling determined the impact of HC, demographics, comorbidities, and select procedures on outcomes.

Overall, 788,715 patients had 968,359 AP hospitalizations (mean [SD]: 1.2 [0.7]). Mean (SD) annual AP hospitalization cost was $24,387 ($55,591), length of stay (LOS) 7.2 (10.9) days, and in-hospital mortality rate 3.3%; 14% had >1 AP hospitalization/y. Patients with AP+HC had 2.0 (1.6) AP hospitalizations, with an annual cost of $40,440 ($51,442) and 12.2 (13.9) hospitalization days/y, and were younger, with a 1.5% in-hospital mortality rate. The average time between hospitalizations was 48.9 to 55.9 days. HC added significantly to the cost (P < .01) and days (P < .0001) of AP hospitalizations.

Patients with AP+HC hospitalizations have significantly greater acute healthcare utilization, with 67% more annual hospitalizations, 66% higher costs, and 71% higher LOS than overall patients hospitalized for AP or hospitalized for HTG-associated AP not diagnosed as chylomicronemia. Interventions targeting triglyceride reduction and addressing the risk of AP in such patients are needed.