P0032 - Extra Ouch? Comparing Outcomes of Acute Pancreatitis in United States Miliary Veterans With and Without Post-Traumatic Stress Disorder

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Has Audio

Presenting Author(s)

Kyle Scholten, DO

University of Nebraska Medical Center
Omaha, NE

Kyle Scholten, DO¹, Kevin Brittan, MD¹, Kaeli Samson, MA, MPH¹, Christine Mitchell, MD², Derrick Antoniak, MD³
¹University of Nebraska Medical Center, Omaha, NE; ²Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE; ³University of Nebraska College of Medicine, Omaha, NE

Introduction: United States (US) military Veterans (USMV) are disproportionately affected by post-traumatic stress disorder (PTSD), which has been shown to impact clinical outcomes in a myriad of conditions. Recent work has shown an association between anxiety disorders and altered pain experience in acute pancreatitis (AP). We aim to explore the relationship between PTSD and clinical outcomes in USMV with AP.

Methods: In this retrospective analysis, admissions for AP to Veterans Affairs (VA) facilities were selected from 2011 through 2017 and grouped by baseline presence of PTSD. Outcomes included length of stay, opioid and benzodiazepine use, major complications, and one-year mortality. Generalized estimating equation Multivariable models accounted for correlations within hospitalizations and were used to generate adjusted odds ratios.

Results: The final analysis included 30,144 patients, of whom 5,044 (17%) had PTSD. At baseline, those with PTSD were younger, had better renal function, and were more likely to have substance use disorders. The PTSD group had higher rates of chronic opioid use before and after admission. In adjusted analysis, however, the rate of new chronic opioid use after admission did not significantly differ from patients without PTSD. Thirty-day readmission, major complication, and mortality were similar between groups (Figure 1).

Discussion: In this retrospective study, we did not find an association between PTSD and important clinical outcomes in Veterans with AP. Rates of opioid use were high in both study groups, requiring further study.

Table 1: Adjusted outcomes by study group
	aOR^a and 95% CI
Readmission	1.095 (0.991, 1.209)
New chronic opioid use^b	0.933 (0.833, 1.044)
Major complications^c	0.964 (0.876, 1.061)
Mortality at 1 year^d	1.023 (0.904 – 1.158)
^aOdds ratios are shown for PTSD vs no PTSD. ^bExcludes patients using opioids chronically preadmission. ^cDefined as a composite of readmission, respiratory or renal failure, ICU transfer (if not initially admitted to non-ICU), persistent systemic inflammatory response syndrome beyond 24 hours, need for enteral or parenteral nutrition, or need for endoscopic or surgical intervention. ^dMortality calculated cumulatively from time of admission.

Table: Table 1: Adjusted outcomes by study group

Disclosures:

Kyle Scholten indicated no relevant financial relationships.

Kevin Brittan indicated no relevant financial relationships.

Kaeli Samson indicated no relevant financial relationships.

Christine Mitchell indicated no relevant financial relationships.

Derrick Antoniak indicated no relevant financial relationships.

Kyle Scholten, DO¹, Kevin Brittan, MD¹, Kaeli Samson, MA, MPH¹, Christine Mitchell, MD², Derrick Antoniak, MD³. P0032 - Extra Ouch? Comparing Outcomes of Acute Pancreatitis in United States Miliary Veterans With and Without Post-Traumatic Stress Disorder, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.