P2102 - Therapeutic Plasma Exchange in Hypertriglyceridemia-Induced Acute Pancreatitis: A Nationwide Descriptive Study

Ikechukwu Achebe, MD¹, Hla Wai, MD², Garima Pudasaini, MD¹, Muhammad Sheharyar Warraich, MD¹, Syed Ali Amir Sherazi, MD¹, Kapil Chhetri, MD¹, Chike Nwokolo, MD³, Sheena Gillani, BSc⁴, Hafeez Shaka, MD^1
1John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ²Stroger, Chicago, IL; ³Franciscan St. James Health, Olympia Fields, IL; ⁴Rosalind Franklin University of Medicine and Science, North Chicago, IL

Introduction: Hypertriglyceridemia (HTG) remains a leading cause of acute pancreatitis and has led to significant patient morbidity and mortality. In patients with severe HTG, prompt reduction of triglyceride levels with Plasma Exchange Therapy (PLEX) has been shown to have benefit. Still, early identification of HTG as a cause of pancreatitis, and timely initiation of PLEX is challenging due to scarce literature describing patients most at risk for needing PLEX. This analysis represents the first nationwide descriptive study that characterizes patients admitted for hypertriglyceridemia-induced acute pancreatitis who received PLEX.

Methods: The National Inpatient Sample (NIS) database was sourced for data involving adult hospitalizations for HTG induced pancreatitis in the US between January 1, 2016 and December 31, 2017. Cohort characteristics and demographic information was extracted in patients who received PLEX, and those who did not. Additionally, we describe average length of stay, total cost of admission, and mortality in each population. All analysis was done using STATA 14 software and ICD 10 codes.

Results: A total of 104,465 hospitalizations for HTG induced pancreatitis was queried within the study period. Patients who received plex, 755 (0.7%) were younger (39.4 vs 56.9, p< 0.001), had less caucasian representation (57.0% vs 64.5%, p< 0.001), had more diabetes (63.4% vs 52.6%, p< 0.008), obesity (36.4% vs 24.5%, p< 0.001), anemia (30.5% vs 17%, p< 0.001), and had a greater percentage of uninsured patients (13.3% vs 5.7%, p< 0.001). Patients with HTG induced pancreatitis had an average length of stay at (8.4 days), a mean total hospital charge of ($87,954), and in-hospital mortality of (1.3%). Hypocalcemia was noted in (41.1%) of patients, (29.1%) had acute kidney failure, (13.3%) had SIRS, and (8%) had sepsis.

Discussion: Findings of younger age, along with higher incidence of obesity, diabetes, and anemia in patients with HTG-Induced pancreatitis who received PLEX, may suggest that patients with comorbid inflammatory disease, are at more risk of severe HTG induced pancreatitis. This may be due to an exaggerated immune response in setting of HTG, and subsequently increased disease severity requiring PLEX. Additional studies need to investigate this further.


Disclosures:


Ikechukwu Achebe, MD¹, Hla Wai, MD², Garima Pudasaini, MD¹, Muhammad Sheharyar Warraich, MD¹, Syed Ali Amir Sherazi, MD¹, Kapil Chhetri, MD¹, Chike Nwokolo, MD³, Sheena Gillani, BSc⁴, Hafeez Shaka, MD¹. P2102 - Therapeutic Plasma Exchange in Hypertriglyceridemia-Induced Acute Pancreatitis: A Nationwide Descriptive Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.