Hospitalization Outcomes of Acute Pancreatitis in Hematopoietic Stem Cell Transplant Recipients

Hunza Chaudhry; Armaan Dhaliwal; Kanwal Bains; Aalam Sohal; Piyush Singla; Raghav Sharma; Dino Dukovic; Isha Kohli; Gagan Gupta; Devang Prajapati

doi:10.14740/gr1579

Hospitalization Outcomes of Acute Pancreatitis in Hematopoietic Stem Cell Transplant Recipients

Gastroenterology Res. 2022 Dec;15(6):334-342. doi: 10.14740/gr1579. Epub 2022 Dec 1.

Authors

Affiliations

¹ Department of Internal Medicine, University of California, San Francisco, Fresno, CA, USA.
² Department of Internal Medicine, University of Arizona, South Campus, Tucson, AZ, USA.
³ Liver Institute Northwest, Seattle, WA, USA.
⁴ Dayanand Medical College and Hospital, India.
⁵ Punjab Institute of Medical Sciences, India.
⁶ Ross University School of Medicine, Barbados.
⁷ Graduate School of Public Health, Icahn School of Medicine, Mount Sinai, New York, NY, USA.
⁸ Department of Gastroenterology and Hepatology, University of California, San Francisco, Fresno, CA, USA.

PMID: 36660472
PMCID: PMC9822663
DOI: 10.14740/gr1579

Abstract

Background: Acute pancreatitis (AP) carries a significant morbidity and mortality worldwide. AP is a potential complication of hematopoietic stem cell transplantation (HSCT) although its incidence remains unclear. HSCT recipients are at increased risk of AP due to various factors but the effect of AP on mortality and resource utilization in the adult population has not been studied. We investigated the impact of AP on hospitalization outcomes among patients following HSCT.

Methods: We queried the National Inpatient Sample (NIS) database using the International Classification of Diseases (ICD)-10 codes. All adult patients with a diagnosis or procedure code of HSCT were included in the study. Patients were divided into those with a diagnosis of AP and those without. Sensitivity analysis was performed for patients with a length of stay greater than 28 days. The relationship between AP and mortality, length of stay, total hospitalization cost, and charges was assessed using univariate analysis followed by multivariate analysis.

Results: Of the 140,130 adult patients with HSCT, 855 (0.61%) patients developed AP. There was 1.74 times higher risk of mortality in patients with AP as compared to controls (adjusted odds ratio (aOR): 1.74, P = 0.0055). There was no statistically significant difference in the length of stay, hospitalization charge, or cost before sensitivity analysis. After sensitivity analysis, 13,240 patients were included, from which 125 (0.94%) had AP. There was 3.85 times higher risk of mortality in patients who developed AP as compared to controls (aOR: 3.85, P = 0.003). There was a statistically significant increase noted in the length of stay (adj coeff: 20.3 days, P = 0.002), hospital charges (+$346,616, P = 0.017), and cost (+$121,932.4, P = 0.001) in patients with AP as compared to those who did not develop AP.

Conclusion: Recipients of HSCT who develop AP have shown to have higher mortality on sensitivity analysis. This study highlights that AP in HSCT patients is associated with worse outcomes and higher resource utilization. Physicians should be aware of this association as the presence of pancreatitis portends a poor prognosis.

Keywords: Acute pancreatitis; Hematopoietic stem cell transplantation; Hospitalization outcomes.