Mortality following acute pancreatitis: social deprivation, hospital size and time of admission: record linkage study

Abstract

BackgroundVery little is known about whether mortality following acute pancreatitis may be influenced by the following five factors: social deprivation, week day of admission, recruitment of junior doctors in August each year, European Working Time Directives (EWTDs) for junior doctors’ working hours and hospital size. The aim of this study was to establish how mortality following acute pancreatitis may be influenced by these five factors in a large cohort study.MethodsSystematic record linkage of inpatient, mortality and primary care data for 10 589 cases of acute pancreatitis in Wales, UK (population 3.0 million), from 1999 to 2010. The main study outcome measure was mortality at 60 days following the date of admission.ResultsMortality was 6.4% at 60 days. There was no significant variation in mortality according to social deprivation or the week day of admission. There was also no significant variation according to calendar month for acute pancreatitis overall or for gallstone aetiology, but for alcoholic acute pancreatitis, mortality was increased significantly by 93% for admissions during the months of August and September and 102% from August to October when compared with all other calendar months. Mortality was increased significantly for alcoholic aetiology in August 2004, the official month that the first EWTD was implemented, but there were no other increases following the first or second EWTDs. There were also indications of increased mortality in large hospitals when compared with small hospitals, for acute pancreatitis overall and for gallstone aetiology but not for alcoholic acute pancreatitis, although these increases in mortality were of quite marginal significance.ConclusionsAlthough we found some evidence of increased mortality for patients admitted with alcoholic acute pancreatitis during August to October, in August 2004, and in large hospitals for acute pancreatitis overall and for gallstone aetiology, the study factors had limited impact on mortality following acute pancreatitis and no significant impact when adjusted for multiple comparisons.

The impact of social deprivation on mortality following acute myocardial infarction, stroke or subarachnoid haemorrhage: A record linkage study

“…When investigating mortality, we also adjusted for age group, gender and comorbidities. Specifically, we adjusted for any impact of the following 11 major patient comorbidities recorded in any diagnostic position during the admission, or within the previous 5 years from primary and inpatient care records where available: ischaemic heart disease (I20–I25) or other cardiovascular diseases (I00–I15, I26–I52), cerebrovascular disease (I60–I69), other circulatory diseases (I70–I99), malignancies (C00–C97), chronic obstructive pulmonary disease (J40–J44), asthma (J45–J46), diabetes (E10–E14), dementia (F00–F03, F05.1, G30), liver disease (K70–K77) and renal failure (N17–N19) [ 27 ].…”

Vaccinium macrocarpon Aiton Extract Ameliorates Inflammation and Hyperalgesia through Oxidative Stress Inhibition in Experimental Acute Pancreatitis

“…Acute pancreatitis (AP) is a disease that leads to pancreatic inflammation, related to the premature activation of digestive enzymes. The incidence of this disease has increased in recent years [ 1 ] which has contributed to a significant increase in mortality, mainly caused by complications of this condition such as the systemic inflammatory response [ 2 ].…”

Identifying risk factors for progression to critical care admission and death among individuals with acute pancreatitis: a record linkage analysis of Scottish healthcare databases

“…Individual estimates of the incidence of AP range from 10 to 78 per 100 000 per year. [1][2][3][4][5][6] AP was found to be the most common reason for hospitalisation with a gastrointestinal disorder in the USA in 2012. 7 The estimated financial cost for AP-related care in the USA in 2004 was $3.7 billion, with AP resulting in 277 000 hospital admissions and 475 000 ambulatory visits.…”