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Sunday Poster Session

Category: Biliary/Pancreas

P0019 - Celiac Disease Is Associated With Increased Risk of Deep Vein Thrombosis and Hypotensive Shock in Patients Admitted With Acute Pancreatitis: A Nationwide Cohort Analysis, 2016-2019

Sunday, October 22, 2023
3:30 PM – 7:00 PM PT
Location: Exhibit Hall
Has Audio
Yazan Abboud, MD1, Vraj Shah, BS1, Yi Jiang, MD2, Navya Pendyala, BA1, Kaveh Hajifathalian, MD, MPH1
1Rutgers New Jersey Medical School, Newark, NJ; 2Cedars-Sinai Medical Center, Los Angeles, CA

Introduction: Celiac disease (CD) has previously been demonstrated to be associated with the development of acute pancreatitis (AP). However, there is a paucity of literature critically analyzing the association of CD with AP outcomes. Therefore, the aim of our study was to conduct a nationwide analysis evaluating the impact of CD on outcomes and complications of AP.

Methods: A retrospective population-based cohort study was performed using the Healthcare Cost and Utilization Project (HCUP)’s National Inpatient Sample (NIS) between 2016-2019. The NIS is the largest inpatient all-payer healthcare database in the US. Using the International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes, the NIS was queried for inpatients with diagnoses of AP. ICD-10 codes were also used to identify diagnoses of CD, comorbidities, outcomes, and complications. Multivariable logistic regression was performed to identify the independent impact of CD on AP outcomes after controlling for demographic, comorbidities, and all patients refined diagnosis-related groups (APR-DRG) risk of severity subclass, which is a classification system based on the severity of illness.

Results: From 2016-2019, a total of 2,253,730 inpatients with AP were identified, of which 4,640 (0.2%) had a diagnosis of AP. When compared to non-CD patients, patients with CD tended to be younger, females, and of White race (P-values< 0.001) (Table 1). On multivariable analysis when controlling for demographics and comorbidities, patients with CD had decreased odds for mortality (odds ratio [OR] 0.387, P< 0.001), pseudocyst formation (OR 0.786, P< 0.001), sepsis (OR 0.707, P< 0.001), respiratory failure (OR 0.806, P=0.022), acute kidney injury (OR 0.804, P< 0.001), and myocardial infarction (OR 0.217, P< 0.001). However, patients with CD were at increased odds for developing deep vein thrombosis (OR 2.24, P< 0.001) and hypotensive shock (OR 1.718, P=0.009). Furthermore, patients with CD had shorter lengths of stay by 0.4 days on average and lower total charges by $12,690.

Discussion: Our nationwide study evaluating AP outcomes in patients with CD suggests that patients with CD who were admitted for AP tend to have better mortality and several other outcomes compared to non-CD patients. However, we also show that CD patients admitted for AP tend to have a greater risk for deep vein thrombosis and hypotensive shock. Future studies are warranted to validate the revealed findings in CD patients admitted for AP.

Figure: Table 2: Multivariable Analysis of Comorbidity Data of Hospitalized Patients with Acute Pancreatitis Associated with Celiac Disease.

 

 

Non-Celiac Disease n=2,249,094 (99.8%)

Celiac Disease

n=4,640 (0.2%)

P-value

Age

Age, years (mean [SE])

52.68 [0.01]

50.56 [0.28]

< 0.001

Sex

Male

52.1%

30.6%

< 0.001

Female

47.9%

69.4%

Race

White

63.7%

85.8%

< 0.001

Black

15.8%

5.2%

Hispanic

14.0%

5.4%

Asian- Pacific Islander

2.5%

2.0%

Native American

0.9%

0.3%

Other

3.1%

1.2%

Median Household Income by Zip Code

0-25th Percentile

32.2%

16.4%

< 0.001

26th-50th Percentile

26.5%

28.2%

51st-75th Percentile

23.6%

27.6%

76th-100th Percentile

17.6%

27.8%

Primary expected payer

Medicare

33.3%

31.3%

< 0.001

Medicaid

24.2%

15.7%

Private insurance

30.3%

45.7%

Self-pay

8.4%

3.4%

No charge

0.7%

0.1%

Other

2.9%

3.8%

Comorbidities

Cholelithiasis

20.3%

13.4%

< 0.001

Choledocholithiasis

8.6%

5.4%

< 0.001

Alcohol abuse/dependence

31.8%

18.8%

< 0.001

Hypertriglyceridemia

5.4%

5.2%

0.540

Bile Duct Obstruction

2.7%

3.3%

0.010

Hypercalcemia

1.0%

0.8%

0.070

Obesity

17.8%

12.0%

< 0.001

Solid Tumor

5.5%

4.6%

0.008

Inflammatory Bowel Disease

1.4%

5.8%

< 0.001

Autoimmune Hepatitis

0.1%

1.2%

< 0.001

 


Table: Table 1: Univariate Analysis of Demographic and Comorbidity Data of Hospitalized Patients with Acute Pancreatitis by Celiac Disease Status.


Disclosures:
Yazan Abboud indicated no relevant financial relationships.
Vraj Shah indicated no relevant financial relationships.
Yi Jiang indicated no relevant financial relationships.
Navya Pendyala indicated no relevant financial relationships.
Kaveh Hajifathalian indicated no relevant financial relationships.


Yazan Abboud, MD1, Vraj Shah, BS1, Yi Jiang, MD2, Navya Pendyala, BA1, Kaveh Hajifathalian, MD, MPH1. P0019 - Celiac Disease Is Associated With Increased Risk of Deep Vein Thrombosis and Hypotensive Shock in Patients Admitted With Acute Pancreatitis: A Nationwide Cohort Analysis, 2016-2019, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.