S116 Outcomes of Acute Pancreatitis in Patients With Aortic Stenosis

Résumé fourni par la source

Introduction: Acute pancreatitis (AP) is associated with a high mortality especially in high-risk patients. Large amounts of fluid administration are necessary to help in cytokine dilution and hence reduce the severity of inflammation. However fluid management may be challenging especially in patients with pre-existing heart disease including valvular heart diseases. We sought to describe the outcomes of acute pancreatitis among patients with aortic stenosis (AS). Methods: We utilized the National Inpatient Sample database to identify patient’s age 18 years and above admitted with a primary diagnosis of acute pancreatitis from 2001 till date. Our primary outcome of interest was mortality while secondary outcomes included length of hospital stay, acute kidney injury requiring hemodialysis and respiratory failure (AKI). We used the appropriate ICD-9-CM codes to identify the diagnoses. Proportions and frequencies were generated for categorical variables and differences were reported using the chi square test. We used student’s t-test and ANOVA to analyze differences in means for continuous variable. Predictors of mortality were assessed using logistic regression. Results: There was a total of 1,356,819 acute pancreatitis admission in the study period. Aortic stenosis was present in 0.5% (n=6,109) of the study population. After a propensity score matching, there was an increase in mortality among patients with AS (aOR 1.49 95% CI 1.16-1.89) independent of age. Patient with AS had a significantly higher length of hospitalization (mean 5.34 days, 95% CI 5.23-5.45), cost of hospitalization (mean $11211, 95% CI $10941-$11481) compared to those without AS (mean LOS 4.78, 95% CI 4.77-4.79, mean cost $9565, 95% CI $9538-$9592).AS was also associated with a higher odds of respiratory failure (aOR 1.35, 95% CI 1.16-1.56). Patients with AS also had more AKI requiring hemodialysis (aOR 1.84, 95% CI 1.60-2.10). Conclusion: Our study highlights an association between acute pancreatitis and adverse in-hospital events. This buttresses the importance of early recognition of complications especially in patients with Acute Pancreatitis. Future studies are needed to elucidate the best management approach in this high risk group of patient.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.