Acute biliary pancreatitis tied to adverse outcomes among elderly patients

12 Sep 2018
Acute biliary pancreatitis tied to adverse outcomes among elderly patients

Hospitalization for acute biliary pancreatitis (ABP) in elderly patients is likely to lead to adverse clinical outcomes, according to a study.

Researchers identified 184,763 primary ABP admissions from the National Readmission Database. Of these, 41 percent involved elderly patients. Outcomes of interest included mortality, severe acute pancreatitis (SAP) and 30-day readmission. These were compared between elderly (aged ≥65 years) and younger patient cohorts (aged <65 years).

In the elderly cohort, rates of index mortality and SAP were 1.96 percent and 21.5 percent, respectively. Elderly patients underwent significantly more endoscopic retrograde cholangiopancreatography (ERCP; 27.5 percent vs 23.6 percent; p<0.001) procedures and less frequent cholecystectomies (44.4 percent vs 58.7 percent; p<0.001) compared with those who were younger.

Elderly patients had greater odds of mortality and SAP, with the odds further increasing with age. Specifically, those aged 85 years showed the highest odds of mortality (odds ratio [OR], 2.2; 95 percent CI, 1.7–2.9) and SAP (OR, 1.3; 1.2–1.4).

Propensity score–matched analysis confirmed that the risks of mortality (OR, 2.8; 2.2–3.5) and SAP (OR, 1.2; 1.1–1.3) were increased in elderly patients.

Notably, older age did not influence 30-day readmission rates.

According to researchers, the findings indicate that elderly individuals comprise a high-risk cohort of ABP patients with poor hospital outcomes. This is alarming given the increasing elderly population.

Additional studies are needed to identify barriers to prompt biliary decompression and cholecystectomy, as well as examine pancreatitis-related complications in elderly patients.

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