J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 14, Number 8, August 2022, pages 293-299

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

Figure 1. Case selection flowchart. HCUP: the Healthcare Cost and Utilization Project; NRD: Nationwide Readmissions Database.

**Table 1.** Demographic and Clinical Characteristics of Crohn’s Disease Patients With and Without Acute Pancreatitis
	AP absent (n = 210,516)	AP present (n = 2,264)	P value
AP: acute pancreatitis; IQR: interquartile range; ESRD: end-stage renal disease; NAFLD: nonalcoholic fatty liver disease; PBC: primary biliary cirrhosis; PSC: primary sclerosing cholangitis.
Median age, n (IQR)	53 (36 - 68)	51 (38 - 64)	0.003
Age group, n (%)
18 - 44	77,815 (37)	814 (36)	< 0.001
45 - 64	68,780 (32.7)	923 (40.8)
65 or older	63,921 (30.4)	527 (23.3)
Sex, n (%)
Male	88,798 (42.2)	972 (42.9)	0.471
Female	121,718 (57.8)	1,292 (57.1)
Median household income for patient’s ZIP code, n (%)
0 - 25th percentile	48,943 (23.2)	577 (25.5)	0.015
26th - 50th percentile	55,798 (26.5)	616 (27.2)
51st - 75th percentile	55,910 (26.6)	586 (25.9)
76th - 100th percentile	49,865 (23.7)	485 (21.4)
Bed size of the hospital, n (%)
Small	33,286 (15.8)	421 (18.6)	< 0.001
Medium	58,752 (27.9)	689 (30.4)
Large	118,478 (56.3)	1,154 (51)
Insurance, n (%)
Medicare	84,990 (40.4)	784 (34.6)	< 0.001
Medicaid	30,336 (14.4)	393 (17.4)
Private insurance	80,711 (38.3)	904 (39.9)
Self-pay	7,620 (3.6)	111 (4.9)
No charge	5,788 (2.7)	61 (2.7)
Other	1,071 (0.5)	11 (0.5)
Hypertension, n (%)	63,054 (30)	774 (34.2)	< 0.001
Diabetes mellitus, n (%)	32,457 (15.4)	423 (18.7)	< 0.001
Obesity, n (%)	24,818 (11.8)	310 (13.7)	0.005
Dyslipidemia, n (%)	44,761 (21.3)	516 (22.8)	0.077
ESRD, n (%)	3,041 (1.4)	30 (1.3)	0.635
Acute kidney failure, n (%)	28,608 (13.6)	404 (17.8)	< 0.001
NAFLD, n (%)	4,894 (2.3)	218 (9.6)	< 0.001
PBC, n (%)	133 (0.1)	3 (0.1)	0.194
PSC, n (%)	53 (0.03)	2 (0.1)	0.063
Gallstone disease, n (%)	2,467 (1.2)	121 (5.3)	< 0.001
Hepatic failure, n (%)	1,604 (0.8)	41 (1.8)	< 0.001
Thrombocytopenia, n (%)	7,825 (3.7)	127 (5.6)	< 0.001
Hypercalcemia, n (%)	1,029 (0.5)	24 (1.1)	< 0.001
Hypokalemia, n (%)	34,391 (16.3)	606 (26.8)	< 0.001

Table 1. Demographic and Clinical Characteristics of Crohn’s Disease Patients With and Without Acute Pancreatitis

AP absent (n = 210,516)

AP present (n = 2,264)

P value

AP: acute pancreatitis; IQR: interquartile range; ESRD: end-stage renal disease; NAFLD: nonalcoholic fatty liver disease; PBC: primary biliary cirrhosis; PSC: primary sclerosing cholangitis.

Median age, n (IQR)

53 (36 - 68)

51 (38 - 64)

0.003

Age group, n (%)

18 - 44

77,815 (37)

814 (36)

< 0.001

45 - 64

68,780 (32.7)

923 (40.8)

65 or older

63,921 (30.4)

527 (23.3)

Sex, n (%)

Male

88,798 (42.2)

972 (42.9)

0.471

Female

121,718 (57.8)

1,292 (57.1)

Median household income for patient’s ZIP code, n (%)

0 - 25th percentile

48,943 (23.2)

577 (25.5)

0.015

26th - 50th percentile

55,798 (26.5)

616 (27.2)

51st - 75th percentile

55,910 (26.6)

586 (25.9)

76th - 100th percentile

49,865 (23.7)

485 (21.4)

Bed size of the hospital, n (%)

Small

33,286 (15.8)

421 (18.6)

< 0.001

Medium

58,752 (27.9)

689 (30.4)

Large

118,478 (56.3)

1,154 (51)

Insurance, n (%)

Medicare

84,990 (40.4)

784 (34.6)

< 0.001

Medicaid

30,336 (14.4)

393 (17.4)

Private insurance

80,711 (38.3)

904 (39.9)

Self-pay

7,620 (3.6)

111 (4.9)

No charge

5,788 (2.7)

61 (2.7)

Other

1,071 (0.5)

11 (0.5)

Hypertension, n (%)

63,054 (30)

774 (34.2)

< 0.001

Diabetes mellitus, n (%)

32,457 (15.4)

423 (18.7)

< 0.001

Obesity, n (%)

24,818 (11.8)

310 (13.7)

0.005

Dyslipidemia, n (%)

44,761 (21.3)

516 (22.8)

0.077

ESRD, n (%)

3,041 (1.4)

30 (1.3)

0.635

Acute kidney failure, n (%)

28,608 (13.6)

404 (17.8)

< 0.001

NAFLD, n (%)

4,894 (2.3)

218 (9.6)

< 0.001

PBC, n (%)

133 (0.1)

3 (0.1)

0.194

PSC, n (%)

53 (0.03)

2 (0.1)

0.063

Gallstone disease, n (%)

2,467 (1.2)

121 (5.3)

< 0.001

Hepatic failure, n (%)

1,604 (0.8)

41 (1.8)

< 0.001

Thrombocytopenia, n (%)

7,825 (3.7)

127 (5.6)

< 0.001

Hypercalcemia, n (%)

1,029 (0.5)

24 (1.1)

< 0.001

Hypokalemia, n (%)

34,391 (16.3)

606 (26.8)

< 0.001

**Table 2.** Etiology of Acute Pancreatitis in Patients With Crohn’s Disease
Etiology	Acute pancreatitis (n = 2,264)
Idiopathic acute pancreatitis	89 (3.9%)
Biliary acute pancreatitis	360 (15.9%)
Alcohol-induced acute pancreatitis	252 (11.1%)
Drug-induced acute pancreatitis	183 (8.1%)
Unspecified acute pancreatitis	1,380 (61%)

Table 2. Etiology of Acute Pancreatitis in Patients With Crohn’s Disease

Etiology

Acute pancreatitis (n = 2,264)

Idiopathic acute pancreatitis

89 (3.9%)

Biliary acute pancreatitis

360 (15.9%)

Alcohol-induced acute pancreatitis

252 (11.1%)

Drug-induced acute pancreatitis

183 (8.1%)

Unspecified acute pancreatitis

1,380 (61%)

**Table 3.** Most Common Causes of 30-Day Nonelective Readmission Among CD Patients With Acute Pancreatitis
30-day readmission primary diagnosis	Rate
Acute pancreatitis	27.1
Crohn’s disease	13
Sepsis	9.7
Acute kidney failure	5.8
Clostridium difficile enterocolitis	1.9
Pseudocyst of pancreas	1.4
Ileus	1.4
Dehydration	1.4
Urinary tract infection	1
Peritoneal adhesions	1

Table 3. Most Common Causes of 30-Day Nonelective Readmission Among CD Patients With Acute Pancreatitis

30-day readmission primary diagnosis

Rate

Acute pancreatitis

27.1

Crohn’s disease

Sepsis

9.7

Acute kidney failure

5.8

Clostridium difficile enterocolitis

1.9

Pseudocyst of pancreas

1.4

Ileus

1.4

Dehydration

1.4

Urinary tract infection

Peritoneal adhesions

**Table 4.** Multivariate Analysis for Factors Associated With Acute Pancreatitis in Patients With Crohn’s Disease
Predictor	P value	Odds ratio	95% CI
CI: confidence interval; NAFLD: nonalcoholic fatty liver disease.
Age (years)
18 - 44	Reference
45 - 64	0.404	1.045	0.944	1.155
≥ 65	< 0.001	0.639	0.567	0.72
Diabetes mellitus	0.002	1.196	1.069	1.337
Hypertension	< 0.001	1.199	1.092	1.316
Gallstone disease	< 0.001	4.047	3.343	4.9
NAFLD	< 0.001	3.568	3.08	4.133
Hepatic failure	0.014	1.505	1.086	2.086
Acute kidney failure	< 0.001	1.288	1.149	1.444
Hypercalcemia	0.001	1.964	1.302	2.965
Hypokalemia	< 0.001	1.741	1.583	1.915
Thrombocytopenia	0.031	1.236	1.024	1.49

Table 4. Multivariate Analysis for Factors Associated With Acute Pancreatitis in Patients With Crohn’s Disease

Predictor

P value

Odds ratio

95% CI

Lower

Upper

CI: confidence interval; NAFLD: nonalcoholic fatty liver disease.

Age (years)

18 - 44

Reference

45 - 64

0.404

1.045

0.944

1.155

≥ 65

< 0.001

0.639

0.567

0.72

Diabetes mellitus

0.002

1.196

1.069

1.337

Hypertension

< 0.001

1.199

1.092

1.316

Gallstone disease

< 0.001

4.047

3.343

4.9

NAFLD

< 0.001

3.568

3.08

4.133

Hepatic failure

0.014

1.505

1.086

2.086

Acute kidney failure

< 0.001

1.288

1.149

1.444

Hypercalcemia

0.001

1.964

1.302

2.965

Hypokalemia

< 0.001

1.741

1.583

1.915

Thrombocytopenia

0.031

1.236

1.024

1.49