Social deprivation does not impact on acute pancreatitis severity and mortality: a single-centre study. Issue 1 (6th February 2023)

• Record Type: Journal Article
• Authors: Lim, Wei Boon; Robertson, Francis P; Nayar, Manu K; Sharp, Linda; Nandhra, Sandip; Pandanaboyana, Sanjay
• Is Part Of: BMJ open gastroenterology. Volume 10:Issue 1(2023)
• Publication Date: 2023-02-06
• Subjects: ACUTE PANCREATITIS -- PANCREATIC DISEASE -- DIABETES MELLITUS; Gastroenterology -- Periodicals; 616.33005
• DOI: 10.1136/bmjgast-2022-001035
• Languages: English
• ISSNs: 2054-4774

Abstract

Abstract : Background and aims: The incidence of acute pancreatitis (AP) is increasing in the UK. Patients with severe AP require a significant amount of resources to support them during their admission. The ability to predict which patients will develop multiorgan dysfunction remains poor leading to a delay in the identification of these patients and a window of opportunity for early intervention is missed. Social deprivation has been linked with increased mortality across surgical specialties. Its role in predicting mortality in patients with AP remains unclear but would allow high-risk patients to be identified early and to focus resources on high-risk populations. Methods: A prospectively collected single-centre database was analysed. English Index of Multiple Deprivation (IMD) was calculated based on postcode. Patients were grouped according to their English IMD quintile. Outcomes measured included all-cause mortality, Intestive care unit (ITU) admission, overall length of stay (LOS) and local pancreatitis-specific complications. Results: 398 patients with AP between 2018 and 2021 were identified. There were significantly more patients with AP in Q1 (IMD 1–2) compared with Q5 (IMD 9–10) (156 vs 38, p<0.001). Patients who were resident in the most deprived areas were significantly younger (52.4 in Q1 vs 65.2 in Q5, p<0.001), and more often smokers (39.1% in Q1 vs 23.7% in Q5, p=0.044) with IHD (95.0% vs 92.1% in Q5, p< 0.001 ). In multivariate modelling, there was no significance difference in pancreatitis-related complications, number of ITU visits, number of organs supported and overall, LOS by IMD quintile. Conclusions: Although there was a significantly higher number of patients admitted to our unit with AP from the most socially deprived quintiles, there was no correlation between social economic deprivation and mortality following AP.