The clinical traits of acute pancreatitis in aging patients: a retrospective analysis of 473 cases

Abstract Background The incidence of acute pancreatitis in aging patients has increasing in recent years. Controversial results about clinical outcomes of acute pancreatitis in aging patients were reported in different literature. The aim of our study was to compare the clinical outcomes of AP in aging patients between 60-79 years old and over 80 years old. Methods 80 patients aged ≥ 80 years old(oldest group) were compared to 393 patients aged 60 to 79 years old(older group). The clinical course, biochemical, radiological data were enrolled. The primary endpoint was to compare the death rate, intensive care unit admission rate and in-hospital length of stay(LOS). The secondary endpoint was operative treatment and the complications of AP. Results Abdominal symptom of abdominal pain (61.3% vs 46.3%, P=0.013) was less in oldest group, while diarrhea(18.3% vs 30.0%, P=0.018), jaundice(8.9% vs 17.5%, P=0.021), dyspnea(11.5% vs 26.3%, P=0.001) were more obvious in older group than oldest group. A higher death rate (8.9% vs 16.3%, P = 0.003) and longer hospital length of stay (11.51±10.19 vs 15.26±11.04, P = 0.001) were found in aging patients aged ≥80 years old. Mean BMI was lower in oldest group compared to older group(22.36±2.89 vs 21.07±3.18, P = 0.001). Multivariate analysis identified aged over 80 years(OR 3.299, 95%CI 1.316-8.269, P=0.011) and organ failure(P<0.05) as independent risk factors of mortality. More severe of AP(OR 11.722, 95%CI 4.780-28.764, P=0.001), abdominal pain(OR 1.906, 95%CI 1.052-3.453, P=0.033) and organ failure(P<0.05) were recognized as influencing intensive care unit rate. Aging patients aged over 80 years old(OR 0.149, 95%CI 2.027-6.268, P=0.001), more severe of AP(OR 0.218, 95%CI 1.567-4.322, P=0.001), female(OR 0.093, 95%CI 0.336-3.542, P=0.018), Jaundice(OR 0.080, 95%CI 0.146-5.324, P=0.038), operative treatment(P<0.05) and organ failure(P<0.05) were the risk factors for LOS.

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Comparison of clinical characteristics and outcomes between alcohol-induced and gallstone-induced acute pancreatitis: An Australian retrospective observational study

SAGE Open Medicine ◽

10.1177/20503121211030837 ◽

2021 ◽

Vol 9 ◽

pp. 205031212110308

Author(s):

Santiago Cegarra Garcia ◽

Michael Toolis ◽

Max Ubels ◽

Taha Mollah ◽

Eldho Paul ◽

...

Keyword(s):

Intensive Care Unit ◽

Mechanical Ventilation ◽

Acute Pancreatitis ◽

Intensive Care ◽

Length Of Stay ◽

Hospital Mortality ◽

Intensive Care Unit Mortality ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Index Of Severity

Objectives: To compare the characteristics and outcomes of patients presenting to hospital with alcohol-induced and gallstone-induced acute pancreatitis. Methods: Retrospective study of all patients with alcohol-induced or gallstone-induced pancreatitis during the period 1 June 2012 to 31 May 2016. The primary outcome measure was hospital mortality. Secondary outcome measures included hospital length of stay, requirements for intensive care unit admission, intensive care unit mortality, mechanical ventilation, renal replacement therapy, requirement of inotropes and total parenteral nutrition. Results: A total of 642 consecutive patients (49% alcohol; 51% gallstone) were included. No statistically significant differences were found between alcohol-induced and gallstone-induced acute pancreatitis with respect to hospital mortality, requirement for intensive care unit admission, intensive care unit mortality and requirement for mechanical ventilation, renal replacement therapy, inotropes or total parenteral nutrition. There was significant difference in hospital length of stay (3.07 versus 4.84; p < 0.0001). On multivariable regression analysis, Bedside Index of Severity in Acute Pancreatitis score (estimate: 0.393; standard error: 0.058; p < 0.0001) and admission haematocrit (estimate: 0.025; standard error: 0.008; p = 0.002) were found to be independently associated with prolonged hospital length of stay. Conclusion: Hospital mortality did not differ between patients with alcohol-induced and gallstone-induced acute pancreatitis. The duration of hospital stay was longer with gallstone-induced pancreatitis. Bedside Index of Severity in Acute Pancreatitis score and admission haematocrit were independently associated with hospital length of stay.

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Multicenter Validation of a Risk Index for Mortality, Intensive Care Unit Stay, and Overall Hospital Length of Stay After Cardiac Surgery

Circulation ◽

10.1161/01.cir.91.3.677 ◽

1995 ◽

Vol 91 (3) ◽

pp. 677-684 ◽

Cited By ~ 255

Author(s):

Jack V. Tu ◽

Susan B. Jaglal ◽

C. David Naylor

Keyword(s):

Intensive Care Unit ◽

Cardiac Surgery ◽

Intensive Care ◽

Length Of Stay ◽

Intensive Care Unit Stay ◽

Risk Index ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Multicenter Validation

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Patient-Specific Factors Drive Intensive Care Unit and Total Hospital Length of Stay in Operative Brain Tumor Patients

World Neurosurgery ◽

10.1016/j.wneu.2021.06.114 ◽

2021 ◽

Author(s):

Adrian E. Jimenez ◽

Pavan P. Shah ◽

Adham M. Khalafallah ◽

Sakibul Huq ◽

Jose L. Porras ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Brain Tumor ◽

Length Of Stay ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Patient Specific ◽

Total Hospital ◽

Tumor Patients ◽

Specific Factors

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Hospital Length of Stay Among Patients Receiving Intermittent Versus Prolonged Piperacillin/Tazobactam Infusion in the Intensive Care Units

Journal of Intensive Care Medicine ◽

10.1177/0885066617708756 ◽

2017 ◽

Vol 33 (2) ◽

pp. 134-141 ◽

Cited By ~ 2

Author(s):

Jeannie D. Chan ◽

Timothy H. Dellit ◽

John B. Lynch

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Randomized Trials ◽

Average Duration ◽

Intermittent Infusion ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Inclusion Criteria ◽

Prolonged Infusion

Objectives: We sought to evaluate clinical outcomes of intensive care unit (ICU) patients following a hospital-wide initiative of prolonged piperacillin/tazobactam (PIP/TAZ) infusion. Methods: Retrospective observational study of patients >18 years old who was hospitalized in the ICU receiving PIP/TAZ for >72 hours during the preimplementation (June 1, 2010 to May 31, 2011) and postimplementation (July 7, 2011 to June 30, 2014) periods. Results: There were 124 and 429 patients who met inclusion criteria with average age of 54.3 and 56.9 years, and average duration of PIP/TAZ therapy was 6.1 ± 2.8 days and 5.9 ± 3.4 days in the pre- and postimplementation period, respectively. Intensive care unit and hospital length of stay (LOS) following initiation of PIP/TAZ were 8.0 ± 8.4 days versus 6.4 ± 6.8 days and 26.3 ± 22.8 days versus 20.4 ± 16.1 days among patients in the pre- and postimplementation periods, respectively. Compared to patients who received intermittent PIP/TAZ infusion, the adjusted difference in ICU and hospital LOS was 0.6 ± 0.8 days (95% confidence interval [CI]: −0.9 to 2.1 days) and 5.6 ± 2.1 days (95% CI: 1.4 - 9.7 days) shorter among patients who received prolonged PIP/TAZ infusion. At hospital discharge, 19 (15.3%) intermittent infusion and 74 (17.2%) prolonged infusion recipients had died. In comparison to intermittent infusion recipients, the adjusted odds ratio for mortality was 1.17 (95% CI: 0.65-2.1) with prolonged infusion. Conclusion: Our study demonstrated a reduction in hospital LOS with prolonged PIP/TAZ infusion among critically ill patients. Randomized trials are needed to further validate these findings.

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Change in alkaline phosphatase activity associated with intensive care unit and hospital length of stay in patients with septic acute kidney injury on continuous renal replacement therapy

BMC Nephrology ◽

10.1186/s12882-018-1028-9 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Seung Don Baek ◽

Jae-Young Kang ◽

Hoon Yu ◽

Seulgi Shin ◽

Hyang-Sook Park ◽

...

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Alkaline Phosphatase ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Length Of Stay ◽

Kidney Injury ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Septic Acute Kidney Injury

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Among Trauma Patients, Younger Men with Ventilator-Associated Pneumonia Have Worse Outcomes Compared to Older Men—An Exploratory Study

Healthcare ◽

10.3390/healthcare7020067 ◽

2019 ◽

Vol 7 (2) ◽

pp. 67

Author(s):

Duraid Younan ◽

Sarah Delozier ◽

Nathaniel McQuay ◽

John Adamski ◽

Aisha Violette ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Length Of Stay ◽

Older Men ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Trauma Patients ◽

Ventilator Associated Pneumonia ◽

Icu Stay ◽

Younger Men

Background: Ventilator-associated pneumonia is associated with significant morbidity. Although the association of gender with outcomes in trauma patients has been debated for years, recently, certain authors have demonstrated a difference. We sought to compare the outcomes of younger men and women to older men and women, among critically ill trauma patients with ventilator-associated pneumonia (VAP). Methods: We reviewed our trauma data base for trauma patients with ventilator-associated pneumonia admitted to our trauma intensive care unit between January 2016 and June 2018. Data collected included demographics, injury mechanism and severity (ISS), admission vital signs and laboratory data and outcome measures including hospital length of stay, ICU stay and survival. Patients were also divided into younger (<50) and older (≥50) to account for hormonal status. Linear regression and binary logistic regression models were performed to compare younger men to older men and younger women to older women, and to examine the association between gender and hospital length of stay (LOS), ICU stay (ICUS), and survival. Results: Forty-five trauma patients admitted to our trauma intensive care unit during the study period (January 2016 to August 2018) had ventilator-associated pneumonia. The average age was 58.9 ± 19.6 years with mean ISS of 18.2 ± 9.8. There were 32 (71.1%) men, 27 (60.0%) White, and 41 (91.1%) had blunt trauma. Mean ICU stay was 14.9 ± 11.4 days and mean total hospital length of stay (LOS) was 21.5 ± 14.6 days. Younger men with VAP had longer hospital LOS 28.6 ± 17.1 days compared to older men 16.7 ± 6.6 days, (p < 0.001) and longer intensive care unit stay 21.6 ± 15.6 days compared to older men 11.9 ± 7.3 days (p = 0.02), there was no significant difference in injury severity (ISS was 22.2 ± 8.4 vs. 17 ± 8, p = 0.09). Conclusions: Among trauma patients with VAP, younger men had longer hospital length of stay and a trend towards longer ICU stay. Further research should focus on the mechanisms behind this difference in outcome using a larger database.

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Use of hospital resources in the care of patients with intermediate risk pulmonary embolism

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872620921601 ◽

2020 ◽

pp. 204887262092160

Author(s):

Alexander E Sullivan ◽

Tara Holder ◽

Tracy Truong ◽

Cynthia L Green ◽

Olamiji Sofela ◽

...

Keyword(s):

Intensive Care Unit ◽

Pulmonary Embolism ◽

Intensive Care ◽

High Risk ◽

Length Of Stay ◽

Intensive Care Unit Admission ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Intermediate Risk ◽

Risk Patients

Background Risk stratification and management of hemodynamically stable pulmonary embolism remains challenging. Professional societies have published stratification schemes, but little is known about the management of patients with intermediate risk pulmonary embolism. We describe the care of these patients at an academic health system. Methods Patient encounters from 1 January 2016 to 30 June 2017 were retrospectively identified utilizing a multihospital, electronic health record-based data warehouse. Using the 2019 European Society of Cardiology criteria, differences in hospital resource utilization, defined as intensive care unit admission, use of invasive therapies, and length of stay, were examined in patients with intermediate risk characteristics. Results A cohort of 322 intermediate risk patients, including 165 intermediate–low and 157 intermediate–high risk patients, was identified. Intermediate–high risk patients more often underwent catheter-directed therapy (14.0% vs. 1.8%; P<0.001) compared to intermediate–low risk patients and had a 50% higher rate of intensive care unit admission (relative risk 1.50; 95% confidence interval 1.06, 2.12; P=0.023). There was no difference in median intensive care unit length of stay (2.7 vs. 2.0 days; P=0.761) or hospital length of stay (5.0 vs. 5.0 days; P=0.775) between intermediate–high risk and intermediate–low risk patients. Patients that underwent invasive therapies had a 3.8-day shorter hospital length of stay (beta –3.75; 95% confidence interval –6.17, –1.32; P=0.002). Conclusion This study presents insights into the hospital resource utilization of patients with intermediate risk pulmonary embolism. The 2019 European Society of Cardiology risk stratification criteria are a clinically relevant scheme that identifies patients more often treated with intensive care unit admission and advanced therapies.

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