Adherence to Guidelines Influenced the Mortality, Hospital Stay, and Health Care System Costs in Patients With Acute Pancreatitis. Issue 8 (September 2022)

• Record Type: Journal Article
• Authors: Ricci, Claudio; Ingaldi, Carlo; Alberici, Laura; Marasco, Giovanni; Pagano, Nico; Mosconi, Cristina; Migliori, Marina; Serra, Carla; Davidovich, Ida; Sermonesi, Giacomo; Alemanni, Luigina Vanessa; Rossini, Benedetta; Isopi, Claudio; Casadei, Riccardo
• Is Part Of: Pancreas. Volume 51:Issue 8(2022)
• Page Start: 943
• Page End: 949
• Publication Date: 2022-09
• Subjects: pancreatitis -- guidelines -- mortality -- costs; Pancreas -- Diseases -- Periodicals; Pancreas -- Periodicals; Neuroendocrine tumors -- Periodicals; 616.37005
• DOI: 10.1097/MPA.0000000000002118
• Languages: English
• ISSNs: 0885-3177

Abstract

Abstract : Objectives: The primary end point was the compliance rate with guidelines. The secondaries were mortality, hospital stay, and costs. Methods: This study included 1904 patients with acute pancreatitis (AP): group A, diagnosed before 2013, and group B, after 2013. Results: The compliance rate was 0.6%. The compliance rates increased for fluid resuscitation (3.3% vs 13.7%, P < 0.001), for antibiotics use (21.9% vs 28.1%, P = 0.002), for oral feeding (55.0% vs 49.7%, P = 0.007), and for correct use of endoscopic retrograde cholangiopancreatography (ERCP) (83% vs 91.9%, P < 0.001). Compliance to severity assessment with computed tomography (odds ratio [OR], 0.4; P = 0.029), parenteral nutrition recommendations (OR, 0.3; P = 0.009), and early surgery (OR, 0.3; P = 0.010) reduced the mortality. Compliance to antibiotic therapy (OR, 0.6; P < 0.001), correct use of parenteral nutrition (OR, 0.3; P < 0.001), correct use of ERCP (OR, 0.5; P < 0.001), and early surgery (OR, 0.3; P = 0.010) reduced hospital stay. The compliance reduced the costs for parenteral nutrition ( P < 0.001), correct use of ERCP ( P = 0.011), and surgery ( P = 0.010). Conclusions: The adherence to guidelines for AP was low. Compliance could reduce mortality, prolonged hospital stay, and costs.