Extrapancreatic Complications in Hospitalized Patients With Mild Acute Pancreatitis Are Associated With Poorer Outcomes

Abstract

ObjectivePatients with acute pancreatitis (AP) are at risk for extrapancreatic complications (EPCs) when admitted to the intensive care unit (ICU). We assessed the prevalence of EPCs in non-ICU AP patients and their outcomes.MethodsWe retrospectively studied EPCs in non-ICU AP patients between 2008 and 2018. Outcomes such as length of stay (LOS), inpatient mortality, and 30-day readmission rates were compared between those with and without EPC.ResultsOf the 830 AP patients, 151 (18.1%) had at least 1 EPC. These included urinary tract infection (15.9%), Clostridium difficile infection (17.2%), pneumonia (7.3%), bacteremia (17.2%), acute kidney injury requiring dialysis (3.3%), gastrointestinal bleeding (12.5%), alcohol withdrawal (24.5%), delirium (14.5%), and falls (1.32%). Patients with EPC had increased mean LOS (6.98 vs 4.42 days; P < 0.001) and 30-day readmissions (32.5% vs 19%; P < 0.001). On multivariate regression, EPCs were independently associated with higher LOS (odds ratio, 1.45 [95% confidence interval, 1.36–1.56]; P < 0.001) and 30-day readmissions (odds ratio, 1.94 [95% confidence interval 1.28–2.95]; P < 0.001).ConclusionsThe EPCs are common among noncritical AP patients and contribute to poor outcomes like increased LOS and 30-day readmissions.

Hazardous Drinking Interventions Delivered During Medical-Surgical Care: Patient and Provider Views

“…Hazardous drinking is common among patients receiving inpatient or outpatient specialty medical-surgical care. About 25% of adults admitted to general hospitals in the US have AUDs or are being treated for drinking consequences (Brgdar et al, 2022); (Shah et al, 2022); (Wei et al, 2015). This likely underrepresents the prevalence of hazardous drinking among medical-surgical patients because alcohol-related problems often go undiagnosed during hospital stays and clinic visits (Danovitch et al, 2021).…”