Disparities in demographics among patients with pancreatitis-related mortality

Abstract

Context: Hospital admissions for pancreatitis are increasing. Factors involved in inpatient mortality have not been previously assessed on a large-scale basis.

Objective: The aim was to study factors associated with pancreatitis-related death in hospitalized patients.

Setting: Retrospective analysis of the 2004 U.S. Healthcare Cost and Utilization Project (HCUP) database was performed using "pancreatitis" as admitting diagnosis and "mortality" as primary endpoint.

Main outcome measures: Age, race, gender, income, length of stay, number of diagnoses, and number of procedures were identified as candidate risk factors associated with death.

Design: Univariate and multivariate logistic regression analyses were performed to identify significant covariates.

Results: In 2004, total of 78,864 patients were admitted with pancreatitis; 2,129 (2.7%) patients died. Complete data were available for 57,068 patients. Age greater than 65 was 3 times more often associated with mortality (OR=2.92; P<0.001), while females were 19% less likely to die (OR=0.81; P<0.001). African American patients were 18% more likely to die than whites (OR=1.18, P=0.025), and increasing length of stay was associated with increasing mortality (more than 14 days compared with less than 3 days: OR=1.24; P=0.004). Patients with more than 3 diagnoses and more than one hospital procedure were 17 times (OR=16.7; P<0.001) and 5 times (OR=5.42; P<0.001) more likely to die, respectively. Compared to the lowest income quartile, patients in the 2nd and 3rd quartiles were 19% (OR=0.81; P=0.004) and 17% (OR=0.83; P=0.016) less likely to die, respectively.

Conclusion: Age greater than 65 years, male gender, multiple diagnoses, African American race and low income are strongly associated with inpatient mortality from pancreatitis. Increased number of procedures and longer length of stay are also highly correlative with death.