ACUTE PANCREATITIS IS ASSOCIATED WITH INCREASED RISK OF MORTALITY AND HEALTH CARE UTILIZATION AMONG HOSPITALIZED PEDIATRIC PATIENTS WITH BONE MARROW TRANSPLANTATION.
DDW ePoster Library. Thavamani A. 05/22/21; 320460; Sa658
Aravind Thavamani
Aravind Thavamani
Contributions
Abstract
Engage with the presenter here during ePoster Session: Pediatric Pancreatic, Liver and Biliary Diseases
On Saturday, May 22, 2021 12:15 - 1 p.m. EDT

Number: Sa658
ACUTE PANCREATITIS IS ASSOCIATED WITH INCREASED RISK OF MORTALITY AND HEALTH CARE UTILIZATION AMONG HOSPITALIZED PEDIATRIC PATIENTS WITH BONE MARROW TRANSPLANTATION.

Society: AGA
Track: Pediatric GI
Category: Pediatric Gastroenterology & Developmental Biology

Author(s): Aravind Thavamani1,2, Krishna Kishore Umapathi3, Jignesh Dalal1,2, Thomas J. Sferra1,2, Senthilkumar Sankararaman1,21 UH Rainbow Babies and Children's Hospital, Cleveland, Ohio, United States; 2 Case Western Reserve University, Cleveland, Ohio, United States; 3 Rush University Medical Center, Chicago, Illinois, United States

Introduction: Acute pancreatitis (AP) is one of the serious complications encountered by patients with bone marrow transplantation (BMT). However, there is lack of data on the impact of acute pancreatitis on mortality and hospital outcomes among pediatric population.

Methods: We analyzed nationally representative, non-overlapping years of the National Inpatient Sample and Kids inpatient databases between 2003 and 2016 including all patients ≤20 years of age who underwent bone marrow transplantation. Patients were divided into those with a diagnosis of AP and without (controls) and compared for demographics, clinical characteristics, comorbid conditions related to bone marrow transplantation or AP, and outcome measures of in-hospital mortality and health care resource utilization (length of hospital stay and total hospitalization charges).

Results: We analyzed a total of 97,119 hospitalizations with BMT. The overall incidence of AP was 1.1% (1096). BMT patients with AP were slightly older (11 years vs 9.5 years, p<0.001). AP population had significantly increased proportion of females, Hispanic race, and public insurance compared to BMT patients without AP, p<0.001 (Table 1). Patients with underlying myelodysplastic syndromes, lymphoid leukemia, non-Hodgkin's lymphoma, aplastic anemias and related bone marrow failure syndromes, and hemophagocytic lymphohistiocytosis (HLH) had increased incidence of AP compared to other indications for BMT, P<0.001 (Table 1). BMT patients with inborn errors of metabolism had relatively lower incidence of AP, P<0.001. The overall mortality rate was 4.2% (4059) but was significantly higher among patients with AP (15.3% vs 4.1%, P<0.001). Multivariate regression analysis showed that AP was independently associated with 1.8 times (95% CI:1.46 to 2.31, P<0.001) increased risk of in-hospital mortality. BMT patients with AP had higher incidence of end-organ failure including acute kidney injury, respiratory failure with increased need for intubation and mechanical ventilation, hypotension, P<0.001 (Table 2). Similarly, AP patients had increased incidence of sepsis, deep vein thrombosis, and parenteral nutrition (Table.2). Further, linear regression models revealed that AP was associated with 22 additional days of hospitalization (95% CI: 20.60 to 23.64, P<0.001) and incurred $190,409 US in hospitalization charges (95% CI: 16934 to 211484, P<0.001).

Conclusion: AP in BMT population is associated with adverse outcomes with increased in-hospital mortality, prolonged hospital stay and higher hospitalization charges. Further studies are necessary to predict the risk of AP development for improved clinical outcomes.
Engage with the presenter here during ePoster Session: Pediatric Pancreatic, Liver and Biliary Diseases
On Saturday, May 22, 2021 12:15 - 1 p.m. EDT

Number: Sa658
ACUTE PANCREATITIS IS ASSOCIATED WITH INCREASED RISK OF MORTALITY AND HEALTH CARE UTILIZATION AMONG HOSPITALIZED PEDIATRIC PATIENTS WITH BONE MARROW TRANSPLANTATION.

Society: AGA
Track: Pediatric GI
Category: Pediatric Gastroenterology & Developmental Biology

Author(s): Aravind Thavamani1,2, Krishna Kishore Umapathi3, Jignesh Dalal1,2, Thomas J. Sferra1,2, Senthilkumar Sankararaman1,21 UH Rainbow Babies and Children's Hospital, Cleveland, Ohio, United States; 2 Case Western Reserve University, Cleveland, Ohio, United States; 3 Rush University Medical Center, Chicago, Illinois, United States

Introduction: Acute pancreatitis (AP) is one of the serious complications encountered by patients with bone marrow transplantation (BMT). However, there is lack of data on the impact of acute pancreatitis on mortality and hospital outcomes among pediatric population.

Methods: We analyzed nationally representative, non-overlapping years of the National Inpatient Sample and Kids inpatient databases between 2003 and 2016 including all patients ≤20 years of age who underwent bone marrow transplantation. Patients were divided into those with a diagnosis of AP and without (controls) and compared for demographics, clinical characteristics, comorbid conditions related to bone marrow transplantation or AP, and outcome measures of in-hospital mortality and health care resource utilization (length of hospital stay and total hospitalization charges).

Results: We analyzed a total of 97,119 hospitalizations with BMT. The overall incidence of AP was 1.1% (1096). BMT patients with AP were slightly older (11 years vs 9.5 years, p<0.001). AP population had significantly increased proportion of females, Hispanic race, and public insurance compared to BMT patients without AP, p<0.001 (Table 1). Patients with underlying myelodysplastic syndromes, lymphoid leukemia, non-Hodgkin's lymphoma, aplastic anemias and related bone marrow failure syndromes, and hemophagocytic lymphohistiocytosis (HLH) had increased incidence of AP compared to other indications for BMT, P<0.001 (Table 1). BMT patients with inborn errors of metabolism had relatively lower incidence of AP, P<0.001. The overall mortality rate was 4.2% (4059) but was significantly higher among patients with AP (15.3% vs 4.1%, P<0.001). Multivariate regression analysis showed that AP was independently associated with 1.8 times (95% CI:1.46 to 2.31, P<0.001) increased risk of in-hospital mortality. BMT patients with AP had higher incidence of end-organ failure including acute kidney injury, respiratory failure with increased need for intubation and mechanical ventilation, hypotension, P<0.001 (Table 2). Similarly, AP patients had increased incidence of sepsis, deep vein thrombosis, and parenteral nutrition (Table.2). Further, linear regression models revealed that AP was associated with 22 additional days of hospitalization (95% CI: 20.60 to 23.64, P<0.001) and incurred $190,409 US in hospitalization charges (95% CI: 16934 to 211484, P<0.001).

Conclusion: AP in BMT population is associated with adverse outcomes with increased in-hospital mortality, prolonged hospital stay and higher hospitalization charges. Further studies are necessary to predict the risk of AP development for improved clinical outcomes.

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