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Morbid Obesity Is Associated With Worse Outcomes and Increased Inpatient Mortality in Patients With Alcohol Induced Acute Pancreatitis
Introduction: The prevalence of obesity in the United States is rising. Obesity is a known comorbidity with various health impacts. Alcohol is a common etiology for acute pancreatitis. Obesity is known to be associated with liver dysfunction. It is unclear to what extent the degree of obesity affect...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089142/ http://dx.doi.org/10.1210/jendso/bvab048.042 |
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author | Shaka, Hafeez Rashad, Essam Achebe, Ikechukwu Asotibe, Jennifer Chiagoziem Palomera, Emmanuel Pudasaini, Garima Warraich, Muhammad-Sheharyar |
author_facet | Shaka, Hafeez Rashad, Essam Achebe, Ikechukwu Asotibe, Jennifer Chiagoziem Palomera, Emmanuel Pudasaini, Garima Warraich, Muhammad-Sheharyar |
author_sort | Shaka, Hafeez |
collection | PubMed |
description | Introduction: The prevalence of obesity in the United States is rising. Obesity is a known comorbidity with various health impacts. Alcohol is a common etiology for acute pancreatitis. Obesity is known to be associated with liver dysfunction. It is unclear to what extent the degree of obesity affects patients with alcohol induced acute pancreatitis (AAP), as nationally representative data are lacking. This study aimed to ascertain the impact of morbid obesity on outcomes of patients with alcohol induced pancreatitis. Methods: Data was obtained from the Nationwide Inpatient Sample database for 2016 and 2017. Hospital discharges of patients 18 years and over with a principal diagnosis of AAP were included. This cohort was divided based on presence of comorbid obesity into nonobese patients, mild-moderately obese patients (MMO) (BMI: 30.0 - 39.9) and morbidly obese patients (MO) (BMI >/=40.0). Primary outcome was inpatient mortality. Secondary outcomes included length of hospital stay (LOS), total hospital charges (THC), discharge diagnoses of hypocalcemia, sepsis, acute renal failure (AKI) and acute respiratory failure (ARF). Multivariate regression analysis was used to adjust for patients’ sociodemographic factors, Charlson comorbidity index as well as hospital characteristics as confounders. Results: A total of 143650 hospitalizations were principally for AAP, with 5.5% and 2.7% of these patients classified as having MMO and MO, respectively. In MO patients, there was increased odds of mortality (aOR=2.99, 95% CI: 1.509 - 5.917, p=0.002) when compared with patients who were nonobese. There was no difference in mortality in patients with MMO (aOR 0.88 95% CI: 0.383 - 2.026, p=0.765) when compared with the nonobese group. MO patients had increased mean LOS of 1.1 days (95% CI: 0.7 - 1.6, p<0.001) as well as THC of $14481 (95% CI: 7894 - 21068, p<0.001), increased odds of hypocalcemia (aOR=1.77, 95% CI: 1.302 - 2.392, p<0.001), sepsis (aOR=1.84, 95% CI: 1.183 - 2.873, p=0.007), AKI (aOR=1.55, 95% CI: 1.257 - 1.912, p<0.001). Conclusion: Morbid obesity has a negative impact on outcomes of patients with AAP. Efforts should be channeled towards promoting alcohol cessation in at-risk patients as a preventative measure, as well as closer monitoring of hospitalized patients with morbid obesity to mitigated these adverse events. |
format | Online Article Text |
id | pubmed-8089142 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-80891422021-05-06 Morbid Obesity Is Associated With Worse Outcomes and Increased Inpatient Mortality in Patients With Alcohol Induced Acute Pancreatitis Shaka, Hafeez Rashad, Essam Achebe, Ikechukwu Asotibe, Jennifer Chiagoziem Palomera, Emmanuel Pudasaini, Garima Warraich, Muhammad-Sheharyar J Endocr Soc Adipose Tissue, Appetite, and Obesity Introduction: The prevalence of obesity in the United States is rising. Obesity is a known comorbidity with various health impacts. Alcohol is a common etiology for acute pancreatitis. Obesity is known to be associated with liver dysfunction. It is unclear to what extent the degree of obesity affects patients with alcohol induced acute pancreatitis (AAP), as nationally representative data are lacking. This study aimed to ascertain the impact of morbid obesity on outcomes of patients with alcohol induced pancreatitis. Methods: Data was obtained from the Nationwide Inpatient Sample database for 2016 and 2017. Hospital discharges of patients 18 years and over with a principal diagnosis of AAP were included. This cohort was divided based on presence of comorbid obesity into nonobese patients, mild-moderately obese patients (MMO) (BMI: 30.0 - 39.9) and morbidly obese patients (MO) (BMI >/=40.0). Primary outcome was inpatient mortality. Secondary outcomes included length of hospital stay (LOS), total hospital charges (THC), discharge diagnoses of hypocalcemia, sepsis, acute renal failure (AKI) and acute respiratory failure (ARF). Multivariate regression analysis was used to adjust for patients’ sociodemographic factors, Charlson comorbidity index as well as hospital characteristics as confounders. Results: A total of 143650 hospitalizations were principally for AAP, with 5.5% and 2.7% of these patients classified as having MMO and MO, respectively. In MO patients, there was increased odds of mortality (aOR=2.99, 95% CI: 1.509 - 5.917, p=0.002) when compared with patients who were nonobese. There was no difference in mortality in patients with MMO (aOR 0.88 95% CI: 0.383 - 2.026, p=0.765) when compared with the nonobese group. MO patients had increased mean LOS of 1.1 days (95% CI: 0.7 - 1.6, p<0.001) as well as THC of $14481 (95% CI: 7894 - 21068, p<0.001), increased odds of hypocalcemia (aOR=1.77, 95% CI: 1.302 - 2.392, p<0.001), sepsis (aOR=1.84, 95% CI: 1.183 - 2.873, p=0.007), AKI (aOR=1.55, 95% CI: 1.257 - 1.912, p<0.001). Conclusion: Morbid obesity has a negative impact on outcomes of patients with AAP. Efforts should be channeled towards promoting alcohol cessation in at-risk patients as a preventative measure, as well as closer monitoring of hospitalized patients with morbid obesity to mitigated these adverse events. Oxford University Press 2021-05-03 /pmc/articles/PMC8089142/ http://dx.doi.org/10.1210/jendso/bvab048.042 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Adipose Tissue, Appetite, and Obesity Shaka, Hafeez Rashad, Essam Achebe, Ikechukwu Asotibe, Jennifer Chiagoziem Palomera, Emmanuel Pudasaini, Garima Warraich, Muhammad-Sheharyar Morbid Obesity Is Associated With Worse Outcomes and Increased Inpatient Mortality in Patients With Alcohol Induced Acute Pancreatitis |
title | Morbid Obesity Is Associated With Worse Outcomes and Increased Inpatient Mortality in Patients With Alcohol Induced Acute Pancreatitis |
title_full | Morbid Obesity Is Associated With Worse Outcomes and Increased Inpatient Mortality in Patients With Alcohol Induced Acute Pancreatitis |
title_fullStr | Morbid Obesity Is Associated With Worse Outcomes and Increased Inpatient Mortality in Patients With Alcohol Induced Acute Pancreatitis |
title_full_unstemmed | Morbid Obesity Is Associated With Worse Outcomes and Increased Inpatient Mortality in Patients With Alcohol Induced Acute Pancreatitis |
title_short | Morbid Obesity Is Associated With Worse Outcomes and Increased Inpatient Mortality in Patients With Alcohol Induced Acute Pancreatitis |
title_sort | morbid obesity is associated with worse outcomes and increased inpatient mortality in patients with alcohol induced acute pancreatitis |
topic | Adipose Tissue, Appetite, and Obesity |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089142/ http://dx.doi.org/10.1210/jendso/bvab048.042 |
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