Hospital frailty risk score predicts worse outcomes in patients with chronic pancreatitis

Sohal, Aalam; Chaudhry, Hunza; Kohli, Isha; Gupta, Gagan; Singla, Piyush; Sharma, Raghav; Dukovic, Dino; Prajapati, Devang

doi:10.20524/aog.2022.0765

Cited by 6 publications

(4 citation statements)

References 33 publications

(21 reference statements)

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“…The database has been described in detail previously. 24 , 25 , 26 Since the data obtained is publicly available de‐identified data, IRB approval was not required.…”

Section: Methodsmentioning

confidence: 99%

Outcomes among patients with hepatorenal syndrome based on hospital teaching and transplant status: Analysis of 159 845 hospitalizations

Sohal,

Chaudhry,

Dukovic

et al. 2023

JGH Open

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Background and AimHepatorenal syndrome (HRS) is a life‐threatening complication of advanced liver disease. This study aimed to examine the impact of hospital teaching/transplant status and availability of liver transplantation on survival among hospitalized patients with HRS in the United States.MethodsPatients with HRS were identified from the national inpatient sample 2016–2019. Information was collected regarding patient demographics, hospital characteristics, liver disease etiology, presence of liver disease decompensations, Elixhauser comorbidities, and interventions. Patients were classified as being treated at three hospital groups: non‐teaching hospitals (NTHs), teaching non‐transplant centers (TNTCs), and teaching transplant centers (TTCs). The relationship between hospital teaching/transplant status and in‐hospital mortality and transplant‐free mortality was examined using multivariable linear and logistic regression analysis.ResultsA total of 159,845 patients met the criteria for HRS. Of these, 24% were admitted to NTHs, 50.8% to TNTCs, and 25.2% to TTCs. Admission to a TTC was independently associated with a lower mortality risk compared to admission to non‐TTCs (aOR = 0.75, 95% CI: 0.68–0.83, P <0.001). Patients at TTCs had a lower transplant‐free mortality risk than those at NTHs (aOR = 0.75, 95% CI: 0.67–0.83, P < 0.001). There was no significant difference in all‐cause or transplant‐free mortality between TNTCs and NTHs.ConclusionPatients with HRS admitted to TTCs have higher disease severity, but significantly improved outcomes compared to those admitted to NTHs. These data suggest opportunities for increased disease awareness and education among NTHs and support early referral for liver transplant evaluation among hospitalized patients with HRS.

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“…The database has been described in detail previously. 24 , 25 , 26 Since the data obtained is publicly available de‐identified data, IRB approval was not required.…”

Section: Methodsmentioning

confidence: 99%

Outcomes among patients with hepatorenal syndrome based on hospital teaching and transplant status: Analysis of 159 845 hospitalizations

Sohal,

Chaudhry,

Dukovic

et al. 2023

JGH Open

Self Cite

View full text Add to dashboard Cite

show abstract

“…It contains information on 35 million weighted hospitalizations annually. Information regarding this data source has been discussed in previous studies [ 17 , 18 ]. Each hospitalization is de-identified and maintained in the NIS as a unique entry with one primary discharge diagnosis and up to 39 secondary diagnoses during that hospitalization, depending on the year of data collection.…”

Section: Methodsmentioning

confidence: 99%

The Impact of Type 2 Myocardial Infarction in Acute Pancreatitis: Analysis of 1.1 Million Hospitalizations and Review of the Literature

Khanna,

Patel,

Singh

et al. 2023

Cureus

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Introduction Acute pancreatitis (AP) is a common inflammatory disorder with acute onset and rapid progression. Studies have reported cardiac injury in patients with AP. It is often thought that stress cardiomyopathy can induce these changes leading to type 2 myocardial infarction (type 2 MI) in AP. Our study aims to assess the prevalence as well as the impact of type 2 MI on outcomes in patients with AP. Methods National Inpatient Sample (NIS) 2016-2020 was used to identify adult patients (age>18) with acute pancreatitis. We excluded patients with STEMI, NSTEMI, pancreatic cancer, or chronic pancreatitis. Patients with missing demographics and mortality were also excluded. Patients were stratified into two groups, based on the presence of type 2 MI. Multivariate logistic regression analysis was performed to assess the impact of concomitant type 2 MI on mortality, sepsis, acute kidney injury (AKI), ICU admission, deep venous thrombosis (DVT), and pulmonary embolism (PE) after adjusting for patient demographics, hospital characteristics, etiology of AP and the Elixhauser comorbidities. Results Of the 1.1 million patients in the study population, only 2315 patients had type 2 MI. The majority of the patients in the type 2 MI group were aged >65 years (49.2%, p<0.001), males (54.6%, p=0.63), White (67.6%, p=0.19), had Medicare insurance (55.5%, p<0.001), and were in the lowest income quartile (34.8%, p=0.12). Patients in the type 2 MI group had a higher incidence of mortality (5.4% vs 0.6%, p<0.001), sepsis (7.1% vs 3.7%, p<0.001), shock (9.3% vs 0.9%, p<0.001), AKI (42.9% vs. 11.8%, p<0.001) and ICU admission (12.1% vs 1.4%, p<0.001). After adjusting for confounding factors, patients in the type 2 MI group were noted to be at higher odds of mortality (aOR=2.4; 95% CI 1.5-3.8, p<0.001). Patients in the type 2 MI group had a longer length of stay (adjusted coefficient=2.1 days; 95% CI 1.4-2.8; p<0.001) and higher total hospitalization charges (adjusted coefficient=$45,088; 95% CI $30,224-$59,952; p<0.001). Conclusion Although the prevalence of type 2 MI in AP is low, the presence of type 2 MI is associated with increased mortality and worse outcomes. Physicians should be aware of this association and these patients should be monitored carefully to prevent worse outcomes.

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“…It contains information on 35 million weighted hospitalizations annually. Information regarding this data source has been discussed in previous studies [15,16]. Each hospitalization is de-identified and maintained in the NIS as a unique entry with one primary discharge diagnosis and up to 39 secondary diagnoses during that hospitalization, depending on the year of data collection.…”

Section: Data Sourcementioning

confidence: 99%

The Effects of Malnutrition on Inpatient Outcomes in Patients With Gastroparesis: A Nationwide Analysis

Patel,

Bains,

Kalra

et al. 2023

Cureus

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IntroductionGastroparesis (GP) is a chronic debilitating gastric motility disorder defined as delayed emptying of the stomach content without mechanical obstruction. It can result in nutritional deficiencies, leading to poor overall outcomes. We assessed the impact of malnutrition on in-hospital outcomes in patients with gastroparesis. MethodsPatients with a primary discharge diagnosis of GP between January 2016 and December 2019 were included in the National Inpatient Sample (NIS) database. Data on patient demographics, hospital characteristics, the Charlson Comorbidity Index (CCI), and the etiology of gastroparesis were collected. The association between malnutrition and outcomes, including mortality, deep vein thrombosis (DVT), pulmonary embolism (PE), sepsis, acute kidney injury (AKI), length of stay (LOS), and total hospitalization charges (THC), were analyzed using the multivariate regression model. ResultsA total of 182,580 patients with gastroparesis were included in the analysis. Patients with gastroparesis and malnutrition had a higher risk of mortality (adjusted odds ratio {aOR}, 3.29; p<0.001), sepsis (aOR, 0.43; p<0.001), DVT (aOR, 2.34; p<0.001), and PE (aOR, 2.68; p<0.001) compared to patients with gastroparesis without malnutrition. No significant difference was noted in the rates of AKI. Patients with malnutrition also had a prolonged LOS (2.96 days; p<0.001) and higher THC ($22,890; p<0.001) compared to patients without malnutrition. ConclusionGastroparesis patients with malnutrition are at a greater risk of worse outcomes than those without malnutrition. The early identification of malnutrition in gastroparesis patients can predict morbidity and mortality and assist in risk stratification to enhance outcomes. Further studies are encouraged to identify factors associated with malnutrition in gastroparesis and the impact of interventions to prevent and treat malnutrition.

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Hospital frailty risk score predicts worse outcomes in patients with chronic pancreatitis

Cited by 6 publications

References 33 publications

Outcomes among patients with hepatorenal syndrome based on hospital teaching and transplant status: Analysis of 159 845 hospitalizations

Outcomes among patients with hepatorenal syndrome based on hospital teaching and transplant status: Analysis of 159 845 hospitalizations

The Impact of Type 2 Myocardial Infarction in Acute Pancreatitis: Analysis of 1.1 Million Hospitalizations and Review of the Literature

The Effects of Malnutrition on Inpatient Outcomes in Patients With Gastroparesis: A Nationwide Analysis

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