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Predictors and outcomes of acute respiratory failure in hospitalised patients with acute pancreatitis
  1. Mahesh Gajendran1,
  2. Bharat Prakash2,
  3. Abhilash Perisetti3,
  4. Chandraprakash Umapathy4,
  5. Vineet Gupta5,
  6. Laura Collins1,
  7. Prashanth Rawla6,
  8. Priyadarshini Loganathan1,
  9. Alok Dwivedi7,
  10. Christopher Dodoo7,
  11. Fortune Unegbu8,
  12. Dan Schuller2,
  13. Hemant Goyal9,10,
  14. Shreyas Saligram4
  1. 1Internal Medicine, Texas Tech University Health Sciences Center El Paso, Paul L Foster School of Medicine, El Paso, Texas, USA
  2. 2Pulmonary and Critical Care Medicine, Texas Tech University Health Sciences Center El Paso, Paul L Foster School of Medicine, El Paso, Texas, USA
  3. 3Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  4. 4Gastroenterology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
  5. 5UCSD, La Jolla, California, USA
  6. 6Internal Medicine, Memorial Hospital of Martinsville and Henry County, Martinsville, Virginia, USA
  7. 7Department of Biostatistics, Texas Tech University Health Sciences Center El Paso, Paul L Foster School of Medicine, El Paso, Texas, USA
  8. 8University of Arizona, Arizona Health Sciences Center, Tucson, Arizona, USA
  9. 9Internal Medicine, Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA
  10. 10Internal Medicine, Mercer University School of Medicine, Macon, Georgia, USA
  1. Correspondence to Dr Mahesh Gajendran, TTUHSC El Paso Foster School of Medicine, El Paso, TX 79905, USA; mahesh.gajendran{at}ttuhsc.edu

Abstract

Background and aim Acute pancreatitis (AP) is associated with organ failures and systemic complications, most commonly acute respiratory failure (ARF) and acute kidney injury. So far, no studies have analysed the predictors and hospitalisation outcomes, of patients with AP who developed ARF. The aim of this study was to measure the prevalence of ARF in AP and to determine the clinical predictors for ARF and mortality in AP.

Methods This is a retrospective cohort study using the Nationwide Inpatient Sample database from the year 2005–2014. The study population consisted of all hospitalisations with a primary or secondary discharge diagnosis of AP, which is further stratified based on the presence of ARF. The outcome measures include in-hospital mortality, hospital length of stay and hospitalisation cost.

Results In our study, about 5.4% of patients with AP had a codiagnosis of ARF, with a mortality rate of 26.5%. The significant predictors for ARF include sepsis, pleural effusion, pneumonia and cardiogenic shock. Key variables that were associated with a higher risk of mortality include mechanical ventilation, age more than 65 years, sepsis and cancer (excluding pancreatic cancer). The presence of ARF increased hospital stay by 8.3 days and hospitalisation charges by US$103 460.

Conclusion In this study, we demonstrate that ARF is a significant risk factor for increased hospital mortality, greater length of stay and higher hospitalisation charges in patients with AP. This underlines significantly higher resource utilisation in patients with a dual diagnosis of AP-ARF.

  • acute pancreatitis
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Footnotes

  • Contributors MG: the conception of the work, data collection, data analysis, and interpretation, drafting the article, critical revision of the article. BP: the conception of the work, drafting the article and critical revision of the article. AP, CU and HG: data analysis and interpretation, critical revision of the article. VG: the conception of the work, critical revision of the article. LC: the conception of the work, data collection, data analysis, and interpretation, drafting the article. PR: critical revision of the article. PL: the conception of the work, drafting the article. AD and CD: data analysis and interpretation. FU: drafting the article. DS and SS: the conception of the work, data interpretation, critical revision of the article.

  • Funding Intramural funding by Texas Tech University Paul L. Foster School of Medicine through Scholarly Activities Research Project. Provided to Mahesh Gajendran and Laura Collins.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Institutional Review Board of the Texas Tech University Health Sciences Center El Paso.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. All data relevant to the study are included in the article or uploaded as supplementary information. The NIS database is available through AHRQ /HCUP agency.

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