Mortality and costs related to severe acute pancreatitis in the intensive care units of Australia and New Zealand (ANZ), 2003-2020

Savio George Barreto; Billingsley Kaambwa; Karthik Venkatesh; Sarah C Sasson; Christopher Andersen; Anthony Delaney; Shailesh Bihari; David Pilcher; P-ANZICS Collaborative

doi:10.1016/j.pan.2023.04.006

Mortality and costs related to severe acute pancreatitis in the intensive care units of Australia and New Zealand (ANZ), 2003-2020

Pancreatology. 2023 Jun;23(4):341-349. doi: 10.1016/j.pan.2023.04.006. Epub 2023 Apr 21.

Authors

Savio George Barreto¹, Billingsley Kaambwa², Karthik Venkatesh³, Sarah C Sasson⁴, Christopher Andersen⁵, Anthony Delaney⁶, Shailesh Bihari⁷, David Pilcher⁸; P-ANZICS Collaborative

Affiliations

¹ Division of Surgery and Perioperative Medicine, Flinders Medical Center, Bedford Park, Adelaide, South Australia, Australia; College of Medicine and Public Health, Flinders University, South Australia, Australia. Electronic address: georgebarreto@yahoo.com.
² College of Medicine and Public Health, Flinders University, South Australia, Australia.
³ Malcolm Fisher Department of Intensive Care, The Royal North Shore Hospital, St Leonards, NSW, 2065, Australia; The Kirby Institute, UNSW, Sydney, Australia.
⁴ The Kirby Institute, UNSW, Sydney, Australia; NSW Health Pathology I.C.P.M.R, Westmead Hospital, Sydney, Australia.
⁵ Malcolm Fisher Department of Intensive Care, The Royal North Shore Hospital, St Leonards, NSW, 2065, Australia; The Kirby Institute, UNSW, Sydney, Australia; Northern Clinical School, University of Sydney, Sydney, NSW, Australia; The George Institute for Global Health, King Street, Newtown, NSW, 2042, Australia.
⁶ Malcolm Fisher Department of Intensive Care, The Royal North Shore Hospital, St Leonards, NSW, 2065, Australia; Northern Clinical School, University of Sydney, Sydney, NSW, Australia.
⁷ College of Medicine and Public Health, Flinders University, South Australia, Australia; Department of ICCU, Flinders Medical Centre, Bedford Park, South Australia, 5042, Australia.
⁸ Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran, Melbourne, Victoria, 3004, Australia; The Australian and New Zealand Intensive Care-Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia; The Australian and New Zealand Intensive Care Society (ANZICS), Centre for Outcome and Resource Evaluation (CORE), 277 Camberwell Road, Camberwell, Victoria, 3124, Australia.

PMID: 37121877
DOI: 10.1016/j.pan.2023.04.006

Abstract

Background and objective: Comprehensive data on the burden of severe acute pancreatitis (SAP) in global intensive care units (ICUs) and trends over time are lacking. Our objective was to compare trends in hospital and ICU mortality, in-hospital and ICU length of stay, and costs related to ICU admission in Australia and New Zealand (ANZ) for SAP.

Methods: We performed a retrospective, observational, cohort study of ICU admissions reported to the ANZ Intensive Care Society Adult Patient Database over three consecutive six-year time periods from 2003 to 2020.

Results: 12,635 patients with SAP from 189 ICUs in ANZ were analysed. No difference in adjusted hospital mortality (11.4% vs 11.5% vs 11.0%, p = 0.85) and ICU mortality rates (7.5% vs 8.0% vs 8.1%, p = 0.73) were noted over the study period. Median length of hospital admission reduced over time (13.9 days in 2003-08, 13.1 days in 2009-14 and 12.5 days in 2015-20; p < 0.01). No difference in length of ICU stay was noted over the study period (p = 0.13). The cost of managing SAP in ANZ ICUs remained constant over the three time periods.

Conclusions: In critically-ill SAP patients in ANZ, no change in mortality has been noted over nearly two decades. There was a slight reduction in hospital stay (1 day), while the length of ICU stay remained unchanged. Given the significant costs related to care of patients with SAP in ICU, these findings highlight the need to prioritise resource allocation for healthcare delivery and targeted clinical research to identify treatments aimed at reducing mortality.

Keywords: Demography; Morbidity; Mortality.

Publication types

Observational Study

MeSH terms

Acute Disease
Adult
Australia / epidemiology
Cohort Studies
Hospital Mortality
Humans
Intensive Care Units
Length of Stay
New Zealand / epidemiology
Pancreatitis* / therapy
Retrospective Studies