Cardiovascular comorbidities predict mortality in acute pancreatitis

Abstract

Background The in-hospital mortality of acute pancreatitis (AP) is determined by severity of AP, but also significantly impacted by patients' comorbidities. Therefore, we aimed to examine the association between comorbid risk-profiles and survival in hospitalized patients admitted with AP. Methods We utilized the German nationwide inpatient statistics to identify all AP patient-cases (ICD code K85) admitted to hospitals in Germany between 2005 and 2019. Hospitalization cases for AP were stratified by survival, and risk factors for in-hospital mortality were examined. Results In total, 797,364 hospitalization-cases of patients admitted due to AP (median age 56.0 [IQR 44.0–71.0] years, 39.2 % females) were treated in Germany 2005–2019. Of these, 22,022 (2.8 %) patients died during hospitalization. AP survivors were younger (56.0 [44.0–71.0] vs. 76.0 [64.0–84.0], P < 0.001), more often males (61.0 % vs. 54.1 %, P < 0.001), and were less often afflicted by cardiovascular risk factors and diseases than non-survivors. Cardiovascular diseases (OR 2.08 (95 %CI 2.02–2.15), P < 0.001) and raising number of cardiovascular diseases (OR 1.48 (95 %CI 1.45–1.50), P < 0.001) were independently associated with increasing mortality. In particular, heart failure (OR 2.16 [95 %CI 2.09–2.24], P < 0.001), peripheral artery disease (OR 1.25 [1.15–1.35], P < 0.001), atrial fibrillation/flutter (OR 1.61 [95 %CI 1.55–1.66], P < 0.001), myocardial infarction (OR 4.71 [95 %CI 4.28–5.18], P < 0.001), pulmonary embolism (OR 12.19 [95 %CI 10.91–13.62], P < 0.001), and stroke (OR 7.21 [95 %CI 6.42–8.11], P < 0.001) were independently associated with in-hospital mortality. Conclusions Between 2005 and 2019, the in-hospital mortality among hospitalized AP patients was 2.8 % in Germany. Presence of cardiovascular diseases was associated with significantly reduced survival in AP patients.