Mehak Bassi, MBBS, Sonmoon Mohapatra, MD, Paris Charilaou, MD, Harikrishna Bandla, MBBS, Capecomorin Pitchumoni, MRCP, FACG
Saint Peter's University Hospital, New Brunswick, NJ
Introduction: Acute pancreatitis (AP) is one of the most common conditions affecting the elderly. Older age is recognized as a marker of severity in most severity scoring systems. In this study, we aim to compare the demographics, clinical and laboratory variables, and outcomes between elderly (age ≥ 65 years) versus younger (age < 65 years) patients with AP. We also aimed to determine the factors associated with increased hospital length of stay (LOS) in elderly individuals admitted with AP.
Methods: For this retrospective study, our hospital's inpatient database was used to identify patients with AP between January 2015 to August 2018. Group differences were tested with Chi-square for categorical variables and t-test/quantile regression analysis for continuous variables. After the univariate analysis was conducted and the clinical relevance of significant variables was assessed, the multivariate accelerated failure time model was used to determine factors affecting LOS.
Results: Among 277 subjects with AP, 64 (23%) were elderly (≥65 y, mean 74.3 ± 0.9 y). Compared to the younger population (age < 65 y, mean 42.5 ± 0.9 y), elderly patients were more associated with Type 2 DM (40.6 % vs 22.5% p=0.004), hypertension (78.1% vs 29.1%, p < 0.001), congestive heart failure (10.9% vs 1.9%, p = 0.001), CKD (12.5% vs 2.8%, p=0.002), malignancy (23.4% vs 5.6%, p < 0.001), coronary artery disease (15.6% versus 2.8%, p < 0.001), and COPD (17.2% vs 4.2%, p < 0.001) [Table 1]. Elderly patients had a higher blood urea nitrogen, creatinine, amylase, and low albumin levels at the time of admission compared to the younger population. The mean LOS was higher in the elderly population (5.2 ± 0.7 vs 4.5 ± 0.2 days, p = 0.037) compared to the younger individuals. Presence of pancreatitis related complications, the performance of cholecystectomy and endoscopic interventions (EUS and ERCP) during the same admission, and higher serum creatinine at the time of admission were independently associated with increased LOS [Table 2].
Discussion: 1. Older age in itself is not a cause of increased mortality or morbidity in AP.
2. Comorbid conditions are commonly associated with older age but not significantly associated with increased LOS in AP.
3. The factors associated with increased LOS in elderly AP patients include the presence of pancreatitis related complications, the performance of cholecystectomy and endoscopic interventions during the same admission, and higher serum creatinine at the time of presentation.
Citation: Mehak Bassi, MBBS, Sonmoon Mohapatra, MD, Paris Charilaou, MD, Harikrishna Bandla, MBBS, Capecomorin Pitchumoni, MRCP, FACG. P0927 - PREDICTORS OF INCREASED HOSPITAL LENGTH OF STAY AMONG ELDERLY INDIVIDUALS WITH ACUTE PANCREATITIS. Program No. P0927. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.