Introduction: Acute pancreatitis (AP) is the leading cause of admissions for gastrointestinal disorders in the United States with annual costs of nearly $2.6 billion. The identification of modifiable risk factors may help lower AP-related hospitalizations. Diabetes mellitus (DM) increases the risk of AP. To date, there have been limited single and multi-center studies with varying results on mortality difference in patients with AP and DM. Our primary aim was to evaluate trends in hospitalizations, mortality and costs in patients with DM and AP using a large national database.
Method: We extracted data from Healthcare Cost and Utilization Project Nationwide Inpatient Sample database from 2012-2014. International Classification of Diseases 9th Version, Clinical Modification codes for adult patients hospitalized with primary diagnosis of AP were used.
Result: Between 2012 and 2014, 1,310,385 patients were admitted with a primary diagnosis of AP. 27.4% were diagnosed with AP-DM. Length of stay was four days for all patients. Cost of stay was $7467 for AP without DM, $7560 and $8482 for AP-DM without and with complications, respectively. Regression analysis for mortality controlling for age, gender, DM, and race showed AP-DM had less odds of mortality than patients without DM (p<0.05). The AP patients who were older than age 65 had 2.5 greater odds of mortality (p<0.05). The AP patients with greater Charlson score were at 1.5 greater odds of mortality (p<0.05).
Conclusion: All patients had the same length of stay. The total mortality was lower in AP-DM but higher overall costs compared to patients without DM. The explanation for these differences is unclear but may relate to higher inpatient services for DM, modifying effects of DM on the course of AP, or the type of care patient received in different types of hospitals. Further studies are needed to determine the effects of DM on inpatient mortality, costs and outcomes in patients with AP.
N. Choi: None. M.E. Garcia: None. B.L. Zakhary: None. M.A. Firek: None. D.I. Kim: None. C.S. Jackson: None. A. Firek: None.