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Temporary Trend, Characteristics and Clinical Outcomes of Acute Pancreatitis Patients Infected with Human Immunodeficiency Virus

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Abstract

Background

Compared to general population, human immunodeficiency virus (HIV) infection may increase frequency of acute pancreatitis (AP); however, evidence regarding effects of HIV infection on AP-related outcomes is limited and controversial.

Aims

We aim to investigate the temporary trend, characteristics and clinical outcomes of AP infected with HIV.

Methods

We reviewed data from the 2003–2014 National Inpatient Sample to identify patients with a primary diagnosis of AP. The primary outcomes (in-hospital mortality, acute respiratory failure, acute kidney injury, and prolonged length of stay [LOS]) and secondary outcomes (gastrointestinal hemorrhage, sepsis and total cost) were compared between patients with and without HIV infection using univariate, multivariable and propensity score matching analyses.

Results

Of 594,106 patients diagnosed with AP, 6775 (1.14%) had HIV infection. Patients with HIV were more likely to be younger, black, male, less likely to be gallstone-related and had lower rate of interventions. Multivariable analyses based on multiple imputation revealed that HIV infection was associated with higher risk of mortality (odds ratio [OR]: 1.74; 95% confidence interval [CI] 1.34–2.25), acute kidney injury (OR: 1.13; 95% CI 1.19–1.44), prolonged LOS (OR: 1.26; 95% CI 1.15–1.37) and 6% higher cost. There were no differences in sepsis, gastrointestinal bleeding, and respiratory failure between groups.

Conclusions

HIV infection is associated with adverse outcomes including increased mortality, acute kidney injury and more healthcare utilization in AP patients. More assertive management strategies like early intravenous fluid resuscitation in HIV patients hospitalized with AP to prevent acute kidney injury may be helpful to improve clinical outcomes.

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Funding

This project was supported by a grant from the National Thirteenth Five Year Plan Major Special Project (No. 2017ZX09304016) and the National Science and Technology Major Project (No. 2017ZX09304030).

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Author notes

  1. Hedong Han and Wei Guo have contributed equally to this work.

Authors and Affiliations

  1. Department of Health Statistics, Second Military Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China

    Hedong Han, Wei Guo, Xiaochun Xiao, Yiming Ruan, Cheng Wu & Jia He

  2. Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China

    Honglei Guo

  3. Department of Cardiology, Virginia Commonwealth University, 1250 E Marshall Street, Richmond, VA, 23298, USA

    Xin Wei

  4. Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 701 82, Örebro, Sweden

    Yang Cao

  5. Tongji University School of Medicine, Shanghai, 200092, China

    Jia He

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  1. Hedong Han
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  2. Wei Guo
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  3. Honglei Guo
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  4. Xin Wei
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Contributions

H.H., W.G. and H.G. designed the research. H.H. and W.G. had full access to the data and conducted all analysis. H.H., H.G. and X.X. wrote the draft of this paper. X.W., Y.R., C.W., and Y.C. revised the article critically. All the authors contributed to the manuscript writing, read and approved the final manuscript. J.H. was the guarantor.

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Correspondence to Jia He.

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Han, H., Guo, W., Guo, H. et al. Temporary Trend, Characteristics and Clinical Outcomes of Acute Pancreatitis Patients Infected with Human Immunodeficiency Virus. Dig Dis Sci 66, 1683–1692 (2021). https://doi.org/10.1007/s10620-020-06355-7

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  • DOI: https://doi.org/10.1007/s10620-020-06355-7

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