Respiratory Failure Increases Mortality Risk 7-Fold in Acute Pancreatitis Patients

Acute respiratory failure (ARF) is associated with a 7-fold higher risk of mortality among inpatients hospitalized with acute pancreatitis, according to a recent study.

Findings from the study were presented at the CHEST 2017 Annual Meeting, which is taking place from October 28 to November 1, 2017, in Toronto, Canada.
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It has been established that ARF is a primary cause of mortality among patients hospitalized with acute pancreatitis. However, less is known about the factors that predict mortality in these patients.

For their study, the researchers evaluated 813,120 patients hospitalized with acute pancreatitis via the Nationwide Inpatient Sample (NIS) from 2012 to 2014. Mean patient age was 58.7 years, and 41.3% of patients were women. All patients included in the study had received a primary diagnosis of acute pancreatitis based on ICD-9-CM codes. Patients with missing information on age, gender, and inpatient mortality were excluded.

Results indicated that 21,415 (2.63%) patients hospitalized with acute pancreatitis also had ARF. Mean length-of-stay had been 16.16 days in patients with ARF, compared with 4.36 days in those without ARF. Furthermore, mean cost of hospitalization was more than 5 times higher in patients with ARF compared with patients without ARF.

Ultimately, the researchers found that rates of mortality had been significantly higher among patients with ARF (17.04%) vs those without ARF (0.3%), even following adjustment for confounders. According to multivariate analysis, factors that predicted mortality in these patients included being older than 80 years, having a Charlson Comorbidity Index score of at least 3, septic shock, acute kidney injury (AKI), disseminated intravascular coagulation (DIC), being on a mechanical ventilator, and needing vasopressors.

“ARF is associated with seven times higher inpatient mortality amongst patients with acute pancreatitis,” the researchers concluded. “Our study shows that elderly patients, AKI, mechanical ventilation, DIC, septic shock, and vasopressor use are predictors of higher mortality in ARF patients while [systematic inflammatory response syndrome] and gender are not.”

—Christina Vogt

Reference:

Karakattu S, Devani K, Reddy C, Hoskere G. Predictors and outcomes of acute respiratory failure amongst the patients hospitalized with acute pancreatitis. CHEST J. 2017;152(4):A217.  http://dx.doi.org/10.1016/j.chest.2017.08.244.