Back to Search Start Over

Detailed Characteristics of Post-discharge Mortality in Acute Pancreatitis.

Authors :
Czapári, Dóra
Váradi, Alex
Farkas, Nelli
Nyári, Gergely
Márta, Katalin
Váncsa, Szilárd
Nagy, Rita
Teutsch, Brigitta
Bunduc, Stefania
Erőss, Bálint
Czakó, László
Vincze, Áron
Izbéki, Ferenc
Papp, Mária
Merkely, Béla
Szentesi, Andrea
Hegyi, Péter
Source :
Gastroenterology (00165085); Sep2023, Vol. 165 Issue 3, p682-695, 14p
Publication Year :
2023

Abstract

The in-hospital survival of patients suffering from acute pancreatitis (AP) is 95% to 98%. However, there is growing evidence that patients discharged after AP may be at risk of serious morbidity and mortality. Here, we aimed to investigate the risk, causes, and predictors of the most severe consequence of the post-AP period: mortality. A total of 2613 well-characterized patients from 25 centers were included and followed by the Hungarian Pancreatic Study Group between 2012 and 2021. A general and a hospital-based population was used as the control group. After an AP episode, patients have an approximately threefold higher incidence rate of mortality than the general population (0.0404 vs 0.0130 person-years). First-year mortality after discharge was almost double than in-hospital mortality (5.5% vs 3.5%), with 3.0% occurring in the first 90-day period. Age, comorbidities, and severity were the most significant independent risk factors for death following AP. Furthermore, multivariate analysis identified creatinine, glucose, and pleural fluid on admission as independent risk factors associated with post-discharge mortality. In the first 90-day period, cardiac failure and AP-related sepsis were among the main causes of death following discharge, and cancer-related cachexia and non–AP-related infection were the key causes in the later phase. Almost as many patients in our cohort died in the first 90-day period after discharge as during their hospital stay. Evaluation of cardiovascular status, follow-up of local complications, and cachexia-preventing oncological care should be an essential part of post-AP patient care. Future study protocols in AP must include at least a 90-day follow-up period after discharge. [Display omitted] Post-discharge mortality in acute pancreatitis is as important as in-hospital mortality. A follow-up plan and a screening program are recommended for patients with acute pancreatitis. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00165085
Volume :
165
Issue :
3
Database :
Supplemental Index
Journal :
Gastroenterology (00165085)
Publication Type :
Academic Journal
Accession number :
169872725
Full Text :
https://doi.org/10.1053/j.gastro.2023.05.028