P1064 - Incidence, Burden and Predictors of One-Year Readmission for Alcohol Acute Pancreatitis

Pedro Palacios, MD¹, Miguel Salazar, MD², Paul T. Kroner, MD, MSc¹, Frank J. Lukens, MD¹, Roberto Simons-Linares, MD, MSc^2
1Mayo Clinic, Jacksonville, FL; ²Cleveland Clinic Foundation, Cleveland, OH

Introduction: Alcohol induced acute pancreatitis (AAP) is the second most common cause of acute pancreatitis (AP) in the United States.

Methods: Retrospective cohort study using the 2016 National Readmission Database. Adult patients admitted with a principal diagnosis of AAP in January were included. The follow up period was 11 months (February-December). The primary outcome was readmission of any cause. The secondary outcomes were mortality, morbidity (shock and intensive care unit stay) and resource utilization (length of stay (LOS), total hospitalization costs and charges) associated with readmission. Independent risk factors for readmission were identified using Cox regression analysis. A modified Bedside Severity Index Score for Acute Pancreatitis (BISAP) was use to classify patients with AAP.

Results: 6,633 index admission were included. The mean age was 45.7 years and 71.0% of patients were male and 73.1% of admissions had a modified BISAP score of 0 during index admission (IA). The 11-month readmission rate was 43.1% (n=2,860) and 1.6% of patients were admitted 5 times. The mortality rate of readmission was 0.5% and the mortality rate during the IA was 1.1% (P=0.03). The three most common causes of readmission were: 1) AAP (32.5%), 2) unspecified AP (14.2%) and 3) alcohol withdrawal (4.9%). Readmitted patients were younger (45.1 vs 46.1 years; P=0.02), more likely to have Charlson Comorbidity Score (CCI) of ≥3 (11.3% vs.9.0%:P=0.02), more likely to be admitted on a weekend day (27.5% vs. 23.8%; P=0.02), more likely to have a BISAP score of 0 (76.3% vs. 70.8%;P< 0.01), more likely to have opioid used disorder (5.4% vs. 3.8%;P=0.02). The mean LOS, total hospitalization charges and costs for readmission was 4.5 days, $34,307 and $8,958, respectively. Independent predictors were CCI score of 2 (adjusted Hazard Ratio [aHR] 1.27; P=0.02) and ≥3(aHR 1.53; P< 0.01), associated chronic AP (aHR 1.64; P< 0.01), other chronic pancreatitis (CP) (aHR 2.14; P< 0.01). Older age (aHR 0.99; P=0.02) and private insurance as primary payer (aHR 0.79; P=0.02) were associated with less odds of readmission.

Discussion: Among patients admitted with AAP, the 11-month readmission rate is 43.1%. Over one-third of readmissions are due to another episode of AP. Readmission is associated with significant resource utilization. Patients with underlying CP seem to have increased risk of readmission. a higher modified BISAP score during index hospitalization was not a predictor for readmission.



Disclosures:


Pedro Palacios, MD¹, Miguel Salazar, MD², Paul T. Kroner, MD, MSc¹, Frank J. Lukens, MD¹, Roberto Simons-Linares, MD, MSc². P1064 - Incidence, Burden and Predictors of One-Year Readmission for Alcohol Acute Pancreatitis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.