Effect of Hospital Teaching Status on Outcomes of Patients With Acute Pancreatitis.

ABSTRACT

Introduction Multiple studies have shown that outcomes of various diseases differ by the hospital teaching status. However, not much is known about the effects of hospital teaching status on outcomes of acute pancreatitis (AP). The aim of this study was to identify if there was an effect of hospital teaching status on the outcomes of AP. Methods The National Inpatient Sample (NIS) database was used to identify patients with a discharge diagnosis of AP from 2016 to 2019. Patients were classified according to whether they were admitted to teaching hospitals (TH) or non-teaching hospitals (NTH). Study outcomes were the length of stay (LOS), total hospitalization cost and charge, sepsis, shock, acute kidney injury, ICU admission, and mortality. Results A total of 1,689,334 patients were included in the study. Of these, 65.06% were in the TH group, while 34.94% were in the NTH group. Patients admitted to TH had a higher incidence of AKI (18.84% vs. 15.79%, p<0.001), shock (4.32% vs. 2.7%, p<0.001), sepsis (4.48% vs. 3.65%, p<0.001), and ICU admissions (4.78% vs. 2.90%, p<0.001) than NTH. Patients admitted to TH also had a higher length of stay (5.82 vs. 4.54 days, p<0.001) and higher hospitalization charges ($47,390 vs. $65,380, p<0.001). The mortality rate in TH was 2.25% compared to 1.5% in NTH (p<0.001). Conclusion Patients admitted to TH had higher mortality as compared to NTH. While the exact reason for this is unknown, it can be partially explained by a higher incidence of AKI, shock, and sepsis. Furthermore, ICU admissions were higher in TH, indicating higher resource utilization.