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Digestive Diseases and Sciences

, Volume 63, Issue 11, pp 2874–2879 | Cite as

Outcomes of Chronic Pancreatitis in the Emergency Department

  • Julia McNabb-Baltar
  • Shadeah L. Suleiman
  • Peter A. Banks
  • Darwin L. Conwell
Original Article

Abstract

Objectives

Chronic pancreatitis (CP) is a debilitating chronic illness. We sought to assess the most common reasons patients with CP visit the Emergency Department (ED), the disposition of ED visit [admission, discharge, death], and evaluate predictors of admission and discharge.

Methods

Within the Health Care Utilization Project Nationwide Emergency Department Sample (NEDS), we focused on patients, 18 years and older, presenting to the emergency department with CP (ICD-9 code 577.1) (2006–2009). Model was fitted to predict the likelihood of admission.

Results

Overall, a weighted sample of 638,310 patients visits for CP were identified, of which 399,559 (62.6%) were admitted, 228,523 (35.8%) were discharged from the ED, 5572 (0.9%) discharged against medical advice, and 4656 (0.7%) had an unknown destination. Of those admitted, 4370 (0.7%) died during the hospital episode. The most associated diagnoses for ED visit were diabetes (28.8%), abdominal pain (25.4%), acute pancreatitis (22.5%), cardiac complication (11.1%), infection (10.1%), and dehydration (8.8%). Multivariable analyses revealed that older (OR = 1.02 P < 0.001), sicker patients (Charlson Comorbidity Index ≥ 3, OR = 2.28 P < 0.001), patients presenting with C. difficile colitis (OR = 23.85 P < 0.001), alcohol withdrawal (OR = 6.71 P < 0.001), and acute pancreatitis (OR = 6.46 P < 0.001) were associated with increased odds of hospitalization.

Conclusions

In this national database, our study demonstrates that diabetes, followed by abdominal pain, acute pancreatitis and cardiac complication, were the most common diagnoses associated with ED visits in patients with chronic pancreatitis. Most patients were admitted following the ED visit. Although C. Difficile colitis was a rare associated diagnosis with an ED visit, it was the strongest predictor of admission.

Keywords

Chronic pancreatitis Emergency department Outcomes 

Notes

Compliance with ethical standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

10620_2018_5206_MOESM1_ESM.docx (12 kb)
Supplementary material 1 (DOCX 11 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Gastroenterology, Hepatology, and EndoscopyCenter for Pancreatic Disease, Brigham and Women’s Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Division of Gastroenterology, Hepatology and NutritionOhio State UniversityColumbusUSA

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