Work

Risk factors for intensive care unit admission in hospitalized patients with acute pancreatitis

Year: 2025

Type: article

Abstract: BACKGROUND: Acute pancreatitis (AP) is afflicted by substantial morbidity and mortality. Besides local/systemic complications and pancreatic necrosis, patients' comorbidities might be underrated as risk factor for intensive care unit (ICU) admission in AP. METHODS: We screened the German nationwide inpatient statistics identifying patients admitted due to AP (ICD-code K85) 2005-2019. AP hospitalizations were stratified for necessity of ICU admission and risk-factors for ICU admission were investigated. RESULTS: Overall, 797,364 patient-hospitalizations due to AP (median age 56.0 [IQR 44.0-71.0] years, 39.2% females) were detected in Germany 2005-2019. Among these, 78,437 (9.8 %) were treated at an ICU. AP patients admitted to an ICU were significantly older (59.0 [46.0-73.0] vs. 56.0 [44.0-71.0], P < 0.001), less often female (35.4 % vs. 39.6 %, P < 0.001), showed an aggravated comorbidity-profile and higher case-fatality than those without ICU admission (13.7 % vs. 1.6 %, P < 0.001). ICU admission was independently associated with increased in-hospital case-fatality (OR 9.82 [95%CI 9.54-10.12], P < 0.001). Strongest independent risk factors for ICU admission regarding patient-characteristics were male sex (OR 1.26 [95%CI 1.23-1.28], P < 0.001), obesity (OR 1.53 [95%CI 1.49-1.57], P < 0.001), diabetes mellitus (OR 1.35 [95%CI 1.33-1.38], P < 0.001), heart failure (OR 2.43 [95%CI 2.37-2.49], P < 0.001) and atrial fibrillation/flutter (OR 1.87 [95%CI 1.82-1.91], P < 0.001). CONCLUSIONS: Approximately 10 % of the hospitalized AP patients had to be admitted on an ICU. Besides AP complications, male sex, obesity, diabetes mellitus, heart failure and atrial fibrillation/flutter were associated with ICU admission.

Source: Clinical Nutrition ESPEN

DOI: 10.1016/j.clnesp.2025.10.011