Ali Jaan, MD1, Ashish Dhawan, MBBS2, Ammad Javaid. Chaudhary, MD3, Nosheen Hafeez, MD4, Mahesh Nepal, MD1, Laraib Fatima. Sheikh, 5, Mark Mcfarland, MD1, Karin Dunnigan, MD1 1Rochester General Hospital, Rochester, NY; 2Gian Sagar Medical College and Hospital, Chandigarh, Chandigarh, India; 3Henry Ford Health, Detroit, MI; 4Baptist Health-University of Arkansas for Medical Sciences, North Little Rock, AR; 5Lahore Medical and Dental College, Rochester, NY
Introduction: Necrotizing pancreatitis (NP) is a severe and life-threatening form of acute pancreatitis and is frequently associated with organ dysfunction, necessitating intensive care management. The presence of Clostridium difficile infection (CDI), a common nosocomial infection, can further complicate the clinical course of NP by exacerbating gastrointestinal symptoms and increasing the risk of sepsis. This study aims to analyze the prevalence and outcomes in NP patients with a concurrent CDI.
Methods: Using the National Readmission Database 2016-2020, we employed the International Classification of Diseases, 10th revision, Clinical Modifications (ICD-10-CM) codes to identify adult patients (age >18 years) admitted with NP. We further stratified NP hospitalizations based on the presence of CDI. Utilizing a multivariate regression model, we compared the outcomes of NP in patients with CDI. STATA 14.2 was utilized for statistical analysis.
Results: We included 68,839 NP patients, of whom 1217 (1.77%) had CDI. Adjusted analysis showed significantly higher odds of mortality (adjusted odds ratio [aOR]:2.99, P< 0.001), septic shock (aOR:4.94, P< 0.01), acute kidney injury requiring dialysis (AKId) (aOR:2.31, P< 0.001) and ICU admission (aOR:3.53, P< 0.001) in NP patients with CDI (Table 1). Pancreatitis-specific complications such as pancreatic pseudocyst, portal vein thrombosis, and infection of necrosis requiring necrosectomy were also higher in patients with a CDI. Moreover, NP patients with CDI also had higher odds of developing abdominal compartment syndrome, a rare life-threatening complication.
Discussion: The presence of CDI in patients with NP is associated with higher rates of pancreatitis-specific complications and significantly worse hospitalization outcomes. These findings underscore the importance of vigilant monitoring and proactive management of CDI in NP patients to improve outcomes and reduce the healthcare burden.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Ali Jaan indicated no relevant financial relationships.
Ashish Dhawan indicated no relevant financial relationships.
Ammad Chaudhary indicated no relevant financial relationships.
Nosheen Hafeez indicated no relevant financial relationships.
Mahesh Nepal indicated no relevant financial relationships.
Laraib Sheikh indicated no relevant financial relationships.
Mark Mcfarland indicated no relevant financial relationships.
Karin Dunnigan indicated no relevant financial relationships.
Ali Jaan, MD1, Ashish Dhawan, MBBS2, Ammad Javaid. Chaudhary, MD3, Nosheen Hafeez, MD4, Mahesh Nepal, MD1, Laraib Fatima. Sheikh, 5, Mark Mcfarland, MD1, Karin Dunnigan, MD1. P0045 - Morbidity of <i>Clostridium difficile</i> in Necrotizing Pancreatitis: Insights from National Data, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
