Impact of protein-calorie malnutrition on outcomes in patients admitted with acute pancreatitis: Insights from the National Inpatient Sample

IF 3.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2025-05-01 DOI:10.1016/j.jacl.2025.04.094

Godbless Ajenaghughrure MD, Fernando Mateo MD, Sila Mateo Faxas MD, Muayad Alzamara MD, Amin Eshghabadi MD, Fayaz Khan MD, M Kenan Rahima MD

{"title":"Impact of protein-calorie malnutrition on outcomes in patients admitted with acute pancreatitis: Insights from the National Inpatient Sample","authors":"Godbless Ajenaghughrure MD, Fernando Mateo MD, Sila Mateo Faxas MD, Muayad Alzamara MD, Amin Eshghabadi MD, Fayaz Khan MD, M Kenan Rahima MD","doi":"10.1016/j.jacl.2025.04.094","DOIUrl":null,"url":null,"abstract":"<div><h3>Background/Synopsis</h3><div>Acute pancreatitis (AP) is a common and potentially life-threatening condition, with malnutrition being an important prognostic factor. Protein-calorie malnutrition (PCM) may exacerbate morbidity, mortality, and resource utilization in AP patients.</div></div><div><h3>Objective/Purpose</h3><div>We analyzed a large national dataset 2017-2021 to assess the impact of PCM on in-hospital outcomes in AP admissions.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the National Inpatient Sample (NIS) from 2017 to 2021. Adult patients with AP were identified and stratified based on the presence or absence of PCM. The primary endpoint was inpatient mortality, while secondary endpoints included gastrointestinal bleeding, cardiogenic shock, cardiac arrest, intubation, and hospital resource utilization. Multivariable logistic regression analysis and Poisson regression were utilized to estimate clinical outcomes, with a significance threshold of P < 0.05.</div></div><div><h3>Results</h3><div>A total of 2,172,229 AP hospitalizations were included, of which 201,870 (9.3%) had PCM. Patients with PCM were older and had a higher prevalence of White (64.2%) and Black (16.4%) individuals compared to the non-PCM group. Mortality was significantly higher in the PCM group (6.5% vs. 1.8%, adjusted OR 3.34, 95% CI 3.18–3.51, P < 0.001). Other complications such as gastrointestinal bleeding (8.9% vs. 3.8%, OR 2.44), cardiac arrest (1.8% vs. 0.7%), cardiogenic shock (1.0% vs. 0.3%, OR 3.08), and intubation (9.7% vs. 2.7%, OR 3.70) were markedly more frequent in the PCM group (all P < 0.001).</div><div>Resource utilization was substantially higher among patients with PCM, with a mean length of stay of 12.3 days (vs. 4.8 days, rate ratio 2.54, P < 0.001) and a mean total cost of $38,674 (vs. $13,591, cost ratio 2.81, P < 0.001).</div></div><div><h3>Conclusions</h3><div>Protein-calorie malnutrition is a strong independent predictor of worse outcomes and higher resource utilization in patients with acute pancreatitis, leading to increased mortality and complications. Early identification and management of malnutrition should be a priority in hospitalized AP patients to mitigate adverse outcomes and reduce healthcare costs. Nutritional interventions integrated into AP care may improve both clinical and economic outcomes.</div></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":"19 3","pages":"Pages e67-e68"},"PeriodicalIF":3.6000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of clinical lipidology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1933287425001709","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}

引用次数: 0

Abstract

Background/Synopsis

Acute pancreatitis (AP) is a common and potentially life-threatening condition, with malnutrition being an important prognostic factor. Protein-calorie malnutrition (PCM) may exacerbate morbidity, mortality, and resource utilization in AP patients.

Objective/Purpose

We analyzed a large national dataset 2017-2021 to assess the impact of PCM on in-hospital outcomes in AP admissions.

Methods

We conducted a retrospective cohort study using the National Inpatient Sample (NIS) from 2017 to 2021. Adult patients with AP were identified and stratified based on the presence or absence of PCM. The primary endpoint was inpatient mortality, while secondary endpoints included gastrointestinal bleeding, cardiogenic shock, cardiac arrest, intubation, and hospital resource utilization. Multivariable logistic regression analysis and Poisson regression were utilized to estimate clinical outcomes, with a significance threshold of P < 0.05.

Results

A total of 2,172,229 AP hospitalizations were included, of which 201,870 (9.3%) had PCM. Patients with PCM were older and had a higher prevalence of White (64.2%) and Black (16.4%) individuals compared to the non-PCM group. Mortality was significantly higher in the PCM group (6.5% vs. 1.8%, adjusted OR 3.34, 95% CI 3.18–3.51, P < 0.001). Other complications such as gastrointestinal bleeding (8.9% vs. 3.8%, OR 2.44), cardiac arrest (1.8% vs. 0.7%), cardiogenic shock (1.0% vs. 0.3%, OR 3.08), and intubation (9.7% vs. 2.7%, OR 3.70) were markedly more frequent in the PCM group (all P < 0.001).

Resource utilization was substantially higher among patients with PCM, with a mean length of stay of 12.3 days (vs. 4.8 days, rate ratio 2.54, P < 0.001) and a mean total cost of $38,674 (vs. $13,591, cost ratio 2.81, P < 0.001).

Conclusions

Protein-calorie malnutrition is a strong independent predictor of worse outcomes and higher resource utilization in patients with acute pancreatitis, leading to increased mortality and complications. Early identification and management of malnutrition should be a priority in hospitalized AP patients to mitigate adverse outcomes and reduce healthcare costs. Nutritional interventions integrated into AP care may improve both clinical and economic outcomes.

查看原文本刊更多论文

蛋白质-卡路里营养不良对急性胰腺炎患者预后的影响：来自全国住院患者样本的见解

背景/概要急性胰腺炎（AP）是一种常见且可能危及生命的疾病，营养不良是一个重要的预后因素。蛋白质热量营养不良（PCM）可能加剧AP患者的发病率、死亡率和资源利用。目的/目的我们分析了2017-2021年的大型国家数据集，以评估PCM对AP入院患者住院结果的影响。方法采用2017 - 2021年全国住院患者样本（NIS）进行回顾性队列研究。根据是否存在PCM对成年AP患者进行鉴定和分层。主要终点是住院患者死亡率，次要终点包括胃肠道出血、心源性休克、心脏骤停、插管和医院资源利用。采用多变量logistic回归分析和泊松回归对临床结果进行估计，显著性阈值为P <；0.05.结果共纳入AP住院患者2172229例，其中PCM患者201870例（9.3%）。与非PCM组相比，PCM患者年龄更大，白人（64.2%）和黑人（16.4%）的患病率更高。PCM组死亡率显著高于PCM组(6.5% vs. 1.8%，调整OR 3.34, 95% CI 3.18-3.51, P <；0.001)。其他并发症如胃肠道出血（8.9% vs. 3.8%, OR 2.44）、心脏骤停（1.8% vs. 0.7%）、心源性休克（1.0% vs. 0.3%, OR 3.08）和插管（9.7% vs. 2.7%, OR 3.70）在PCM组中明显更常见(P <；0.001)。PCM患者的资源利用率明显更高，平均住院时间为12.3天(vs. 4.8天，率比2.54,P <；0.001)，平均总成本为38,674美元(vs. 13,591美元，成本比2.81,P <；0.001)。结论蛋白质热量营养不良是急性胰腺炎患者预后恶化和资源利用率提高的一个强有力的独立预测因素，导致死亡率和并发症增加。早期识别和管理营养不良应该是住院AP患者的优先事项，以减轻不良后果并降低医疗保健费用。将营养干预纳入AP护理可以改善临床和经济结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. Sections of Journal of clinical lipidology will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.