Cost and Clinical Characteristics of Acute Pancreatitis Hospitalizations Related and Unrelated to Hypertriglyceridemia
Author(s)
Alec Kleinman, BSc1, Jen Kammerer, BSc, MSc, PharmD2, Nathan Kleinman, PhD1, Nihar R Desai, MD, MPH3.
1Kleinman Analytic Solutions, Paso Robles, CA, USA, 2Medical Value Evidence & Outcomes, Arrowhead Pharmaceuticals, Pasadena, CA, USA, 3Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, USA.
1Kleinman Analytic Solutions, Paso Robles, CA, USA, 2Medical Value Evidence & Outcomes, Arrowhead Pharmaceuticals, Pasadena, CA, USA, 3Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, USA.
Presentation Documents
OBJECTIVES: To describe total hospitalization cost (THC), length of stay (LOS), and mortality rates (MR) in patients with acute pancreatitis (AP) with/without hypertriglyceridemia (HTG), familial chylomicronemia (FCS), substance-related, infected/necrotic pancreas.
METHODS: Using the Nationwide Inpatient Sample, cohorts are descriptively characterized, including frequency distribution, comorbidities, and billed Diagnostic Related Group (DRG). Generalized linear and logistic regression models were used to examine independent predictor variables for THC, LOS, and MR. Independent variables included age, sex, LOS, indicators for death, FCS, HTG, sepsis, infected necrosis, uninfected necrosis, substance-related, diabetic ketoacidosis, DRG with complication/comorbidity (CC), and DRG with major CC. Regression-adjusted outcomes will be produced and THC subsequently inflation-adjusted to current dollars, with p-values for cohort comparisons and significance of independent variables on outcomes.
RESULTS: Over 350,000 hospitalizations informed the models. Respectively, predicted THC and LOS were as follows for hospitalizations with: AP $15,631 and 5.59 days; AP+FCS $19,398 and 6.63 days; AP+HTG $17,303 and 5.48 days; AP+FCS or AP+HTG $17,324 and 5.48 days; AP+ infected necrosis $16,893 and 11.40 days; and substance-related AP $15,144 and 5.46 days. Of note, unadjusted THC mirrored aforementioned, except AP+infected necrosis, which was 4-fold higher ($61,244). Predicted MR was: AP 2.46%; AP+FCS 5.71%; AP+HTG 1.51%; AP+ FCS or AP+HTG 1.52%, AP+infected necrosis 2.24%; and drug-/alcohol-related AP 2.09%. All independent variables were significant (p<0.05) in THC and LOS models, and most were significant in MR model. Holding other variables constant, largest influences on THC were death and major CC, on LOS were sepsis and infected necrosis, and on MR were sepsis and FCS.
CONCLUSIONS: Total hospitalization costs, length of stay, and mortality rates for acute pancreatitis varied across pre-specified subsets. Sepsis, FCS, infected necrosis, and other major complications and comorbidities were predictive of significantly worse outcomes.
METHODS: Using the Nationwide Inpatient Sample, cohorts are descriptively characterized, including frequency distribution, comorbidities, and billed Diagnostic Related Group (DRG). Generalized linear and logistic regression models were used to examine independent predictor variables for THC, LOS, and MR. Independent variables included age, sex, LOS, indicators for death, FCS, HTG, sepsis, infected necrosis, uninfected necrosis, substance-related, diabetic ketoacidosis, DRG with complication/comorbidity (CC), and DRG with major CC. Regression-adjusted outcomes will be produced and THC subsequently inflation-adjusted to current dollars, with p-values for cohort comparisons and significance of independent variables on outcomes.
RESULTS: Over 350,000 hospitalizations informed the models. Respectively, predicted THC and LOS were as follows for hospitalizations with: AP $15,631 and 5.59 days; AP+FCS $19,398 and 6.63 days; AP+HTG $17,303 and 5.48 days; AP+FCS or AP+HTG $17,324 and 5.48 days; AP+ infected necrosis $16,893 and 11.40 days; and substance-related AP $15,144 and 5.46 days. Of note, unadjusted THC mirrored aforementioned, except AP+infected necrosis, which was 4-fold higher ($61,244). Predicted MR was: AP 2.46%; AP+FCS 5.71%; AP+HTG 1.51%; AP+ FCS or AP+HTG 1.52%, AP+infected necrosis 2.24%; and drug-/alcohol-related AP 2.09%. All independent variables were significant (p<0.05) in THC and LOS models, and most were significant in MR model. Holding other variables constant, largest influences on THC were death and major CC, on LOS were sepsis and infected necrosis, and on MR were sepsis and FCS.
CONCLUSIONS: Total hospitalization costs, length of stay, and mortality rates for acute pancreatitis varied across pre-specified subsets. Sepsis, FCS, infected necrosis, and other major complications and comorbidities were predictive of significantly worse outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE322
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Thresholds & Opportunity Cost, Value of Information
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Gastrointestinal Disorders, SDC: Rare & Orphan Diseases