Outcomes of Patients With Acute Pancreatitis: Effect of Medical Versus Surgical Unit Admission

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Conference Proceeding

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American Journal of Gastroenterology


Introduction: Managed equally under medical and surgical services, few studies have reported the difference in outcomes in patients with acute pancreatitis admitted to medical or surgical units, majority of which included patients with gallstone pancreatitis. Our study aims to evaluate the trends in hospitalizations with acute pancreatitis of any etiology and differences in outcomes according to their unit of admission. Methods: A multicentric retrospective review of hospitalized patients $18 years old at a major tertiary care health system in Michigan, USA from 2010-2019 was performed. Variables extracted included demographic details, admission/discharge dates, first unit of admission from the emergency room, and biochemical parameters. Outcomes assessed were percentages of patients requiring ICU admission, length of stay (LOS), mortality, and 30-day readmission rate. Data were analyzed using Stata 14.1. Results: A total of 11,019 patient hospitalizations (5350 [48.6%] female; mean age [6SD] 55617.6 years) with acute pancreatitis were reviewed, out of which 8,712 were admitted to medical units and 2,044 to surgical units. Higher proportion of patients on surgical units were admitted to the ICU (20.6% vs 4.8%, P, 0.001, Table 1). LOS was shorter for patients admitted in medical units (4.1 vs 4.8 days, P, 0.0001) and the medical ICU (7 vs 9.1 days, P, 0.0001). Patients admitted under medical units had a lower mortality (1.3% vs 1.9%, P50.025). There was no difference in readmission rates between medical and surgical units. Conclusion: Patients with acute pancreatitis admitted under medical units had a shorter length of stay and lower mortality as compared to surgical units, therefore showing effective medical management of pancreatitis in medical units. Differences in clinical practices between these 2 units, etiology, and severity of acute pancreatitis at admission may have contributed to these results. To the best of our knowledge, our study is the first to report the comparison of outcomes in management of pancreatitis between surgical and medical units





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American College of Gastroenterology Annual Scientific Meeting, October 20-25, 2023, Vancouver, Canada