Abstract
Background
The objective of this study was to perform a national review of patients with acute
pancreatitis (AP) who undergo pancreatic debridement (PD) to evaluate for risk factors
of in-hospital mortality.
Methods
The Nationwide Inpatient Sample was used to identify patients with AP who underwent
PD between 1998 and 2010. Risk factors for in-hospital mortality were assessed with
multivariate logistic regression.
Results
From 1998 to 2010, there were 585,978 nonelective admissions with AP, of which 1,783
(.3%) underwent PD. From 1998 to 2010, the incidence of PD decreased from .44% to
.25% (P < .01) and PD in-hospital mortality decreased from 29.0% to 15% (P < .05). Of patients undergoing PD, independent factors associated with increased
odds of mortality were increased age (odds ratio [OR] 1.04, confidence interval [CI]
1.03 to 1.05; P < .01), sepsis with organ failure (OR 1.76, CI 1.24 to 2.51; P < .01), peptic ulcer disease (OR 1.83, CI 1.02 to 3.30; P < .05), liver disease (OR 2.27, CI 1.36 to 3.78; P < .01), and renal insufficiency (OR 1.78, CI 1.14 to 2.78; P < .05).
Conclusions
The incidence and operative mortality of PD have decreased significantly over the
last decade in the United States with higher odds of dying in patients who are older,
with chronic liver, renal, or ulcer disease, and higher rates of sepsis with organ
failure.
Keywords
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Article info
Publication history
Published online: March 31, 2014
Received in revised form:
November 11,
2013
Received:
September 18,
2013
Footnotes
The corresponding author and all of the co-authors have no relevant conflicts of interest or support to disclose.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
