Prevalence and Impact of Acute Pancreatitis on Hospitalization Outcomes in a Cohort of Patients With Crohn's Disease.

ABSTRACT

Background: Few studies evaluated the risk of acute pancreatitis (AP) in patients with Crohn's disease (CD). It's controversial if AP can be considered as an extraintestinal manifestation of CD. We studied this potential association in a retrospective cohort of patients with CD. Methods: We draw our cohort from the Nationwide Readmission Databases 2016 - 2018. We used the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes to identify all adult patients admitted with a diagnosis of CD. Patient with a comorbid AP were identified. We analyzed the significant impact of AP on hospitalization outcomes. A multivariate regression analysis was used to identify factors associated with AP. Results: We included 214,622 patients discharged from an index hospitalization for CD, 1.1% had AP. AP was independently associated with higher odds of inpatient mortality (odds ratio (OR) 1.831; 95% confidence interval (CI) 1.345 - 2.492, P < 0.001), gallstone disease (OR 4.047; 95% CI 3.343 - 4.9, P < 0.001), nonalcoholic fatty liver disease (NAFLD) (OR 3.568; 95% CI 3.08 - 4.133, P < 0.001), and hypercalcemia (OR 1.964; 95% CI 1.302 - 2.965, P = 0.001). Thirty-day readmission analysis showed that CD patients with AP were more commonly to be readmitted for AP than for any other reason. Conclusions: In our nationwide cohort of CD patients, there was a significant association between AP and worse hospitalization outcomes. Additionally, we found independent associations for having AP that may help identify patients at high risk.