Acute biliary pancreatitis tied to adverse outcomes in elderly patients
Elderly patients (≥65 years) hospitalized with acute biliary pancreatitis (ABP) are at increased risk of adverse clinical outcomes, a study has shown.
Effective management strategies for this demographic are needed as the ageing population increases nationally, the authors said.
Forty-one percent of the 184,763 ABP admissions comprised elderly patients. Index mortality was 1.96 percent and severe acute pancreatitis (SAP) was 21.5 percent.
Elderly patients had more endoscopic retrograde cholangiopancreatography (ERCP) examinations (27.5 percent vs 23.6 percent; p<0.001) and less frequent cholecystectomies (44.4 percent vs 58.7 percent; p<0.001). They also had greater risks of mortality and SAP as well as an age-dependent increase in risks of adverse outcomes.
Within the elderly cohort, those aged ≥85 years had the highest risks of SAP (odds ratio [OR], 1.3, 95 percent CI, 1.2–1.4) and mortality (OR, 2.2, 1.7–2.9). This was validated in propensity score–matched analysis, which found increased odds of mortality (OR, 2.8, 2.2–3.5) and SAP (OR, 1.2, 1.1–1.3) in the elderly patients.
This study obtained 1-year longitudinal follow-up data of inpatients from the National Readmission Database. The authors evaluated all adult inpatients (≥18 years old) with an index primary admission for ABP between 2011 and 2014 for the following clinical outcomes: mortality, SAP and 30-day readmission. Multivariate and one-to-one propensity score–matched analyses were performed to compare outcomes between age groups (≥65 vs <65 years).
“In the elderly, acute pancreatitis [occurs] most frequently because of gallstones,” the authors said. “[H]owever, there is a paucity of national estimates evaluating outcomes of ABP.”