Abstract
Comparative analysis of outcomes and readmissions trends in adult and pediatric biliary acute pancreatitis
Gastroenterology, Vol.169(1 Supplement), pp.S795-S796
05/03/2025
DOI: 10.1016/S0016-5085(25)02779-9
Abstract
Background Biliary acute pancreatitis (BAP) is the leading identifiable cause of acute pancreatitis (AP), with its incidence rising in adults and children due to increasing obesity and gallstone prevalence. BAP has high recurrence rates and an elevated risk of local complications, presenting a management challenge. Given limited data comparing BAP outcomes and resource utilization, we evaluated differences in outcomes between adult and pediatric BAP hospitalizations. Methods We used the National Readmission Database (2016–2020) to identify patients with a principal diagnosis of BAP using ICD-10 codes. Local and systemic AP complications were compared between adults (age ≥18 years) and pediatric patients (age <18 years). Patients with pancreatic necrosis were initially excluded (included in analysis for local AP complications). Proportions were analyzed using Fisher’s exact test, and multivariate logistic regression was performed, adjusting for age, gender, comorbidities, procedure volume, and patient and hospital factors. Longitudinal readmission trends were assessed using the Mantel-Haenszel test. Analyses were conducted with Stata, version 14.2, with statistical significance set at P<0.05. Results: Among 194,441 BAP patients, 1.54% (n=2,999) were pediatric cases. Systemic complications of AP were largely comparable between groups, except for a higher sepsis risk in adults (0.41% vs. 1.72%, P<0.01) (Figure 1). Similarly, local complications, including pseudocyst, pancreatic necrosis, and walled-off necrosis, were comparable across groups. Mortality from BAP was minimal (0% vs. 0.71%) with no significant difference (P=0.22), while AKI and ICU stays were more frequent in adults. Notably, same-admission cholecystectomy (CCY) was performed more in pediatric cases, whereas ERCP was more common in adults. Same-admission CCY reduced 30-day readmission rates in both groups (11% to 5% in pediatric patients; 12% to 4% in adults), without a significant additional difference between groups (P=0.88). Longitudinal analysis showed static trends in same-admission CCY for pediatric patients (though consistently higher than adults) and a slight increase in adults from 56% in 2016 to 57% in 2020 (trend P=0.01) (Figure.2). In both groups, 30-day readmission rates declined where same-admission CCY was performed. Discussion Local and systemic complications of BAP are largely similar across age groups, though adults experience more severe presentations (e.g., higher sepsis and ICU stays), potentially explaining lower rates of same-admission CCY compared to pediatric cases. Encouragingly, trends in same-admission CCY among adults are improving. Declining 30-day readmission rates in both groups highlight the benefits of timely surgical intervention, emphasizing its importance irrespective of age.
Details
- Title: Subtitle
- Comparative analysis of outcomes and readmissions trends in adult and pediatric biliary acute pancreatitis
- Creators
- Umar Farooq - University of Iowa, Hematology, Oncology, and Blood & Marrow TransplantationZahid TararSagar PathakAli Jaan - Rochester General HospitalUmar Hayat - Geisinger Wyoming Valley Medical CenterAbdullah Abbasi - University of Iowa, Internal MedicineFaisal KamalMuhammad K HasanMustafa A Arain - AdventHealth Orlando
- Resource Type
- Abstract
- Publication Details
- Gastroenterology, Vol.169(1 Supplement), pp.S795-S796
- DOI
- 10.1016/S0016-5085(25)02779-9
- ISSN
- 0016-5085
- eISSN
- 1528-0012
- Publisher
- Elsevier
- Language
- English
- Date published
- 05/03/2025
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984844346402771
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