University Hospitals Case Medical Center, Case Western Reserve University Cleveland Heights, OH, United States
Dayyan Adoor, MD1, Mohammed Z. Sheriff, MD2, Amitabh Chak, MD3 1University Hospitals Case Medical Center, Case Western Reserve University, Cleveland Heights, OH; 2University Hospitals Cleveland Medical Center, Cleveland Heights, OH; 3University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH
Introduction: Acute pancreatitis (AP) can occur after CABG surgery and is attributed to a post-operative hypoperfusion state that causes end organ inflammation and damage. Large scale studies assessing the incidence and demographic features of those who develop AP after CABG surgery are limited.
Methods: We evaluated the incidence of AP among patients who had undergone CABG using a large commercial database called Explorys, which is an aggregate of electronic health data from 27 US healthcare systems. Among patients active in the database between October 2015 and October 2020, we identified all patients who had undergone a CABG surgery, based on the Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT). Within this cohort, we calculated the incidence of AP within the first 30 days after the surgery. Our controls were the same population using the calculated incidence of AP at six months (between 180 and 210 days) after CABG surgery. We further characterized the data by stratifying for age, race and gender. To avoid confounding variables, we excluded all patients who had a previous history of alcohol abuse, gallstone pancreatitis, ERCP, and hypertriglyceridemia.
Results: Of the 37,901,510 individuals active in the database between October 2015 and October 2020, we identified a total of 225,330 individuals who had undergone a CABG surgery. The overall incidence of AP within the first 30 days after surgery was 0.50%. The overall incidence of AP was 4.5 times higher within the first 30 days after surgery (Incidence ratio (IR): 4.48; 95CI 3.91, 5.14, P< 0.01) (Refer to table 1) compared to at six months. Incidence at 30 days was higher among adults (18-65 years old) compared to elderly ( >65 years) (IR: 1.85; 95CI 1.64, 2.08, p< 0.01). Similarly, incidence was greater among African Americans (IR: 1.42; 95CI 1.56, 1.74 p< 0.01) and females (IR: 1.55; 95CI 1.38, 1.74, p< 0.01).
Within the 30-day post-CABG cohort, we also found that chronic kidney disease (CKD) was associated with an increased risk of developing acute pancreatitis (IR: 1.90; 95CI 1.69, 2.14, P< 0.01)
Discussion: Our study confirms an increased risk of AP after CABG surgery. Younger age, African American race, female gender, and CKD are risk factors for developing AP after CABG.
Figure: Incidence of Acute Pancreatitis between 1 and 30 days post CABG compared to 180 and 210 days post CABG. *Incidence per 100,000 cases
Dayyan Adoor indicated no relevant financial relationships.
Mohammed Sheriff indicated no relevant financial relationships.
Amitabh Chak indicated no relevant financial relationships.
Dayyan Adoor, MD1, Mohammed Z. Sheriff, MD2, Amitabh Chak, MD3. P0040 - Incidence of Acute Pancreatitis After Coronary Artery Bypass Graft (CABG) Surgery, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.