Kumar, Vineeth V; Treacy, P John; Li, Minghao; Dharmawardane, Anoj

Author(s)

Kumar, Vineeth V

Treacy, P John

Li, Minghao

Dharmawardane, Anoj

Publication Date

2018-07-08

Abstract

Acute pancreatitis (AP) is a common cause for hospital admission, but some patients have a prolonged stay. The aim of this study was to identify patients with mild AP who had a prolonged hospital stay, who potentially could be discharged at day 2 to enhanced outpatient care. Data was retrospectively collected on all patients admitted to the Royal Darwin Hospital between May 2016 and February 2017 with a diagnosis of mild AP to identify factors that may safely predict early discharge to enhanced outpatient care. Of 115 admissions, 62% were male, 50% indigenous and alcohol was causative in 53%. A total of 75 (65%) patients stayed more than 2 days and used 342 bed-days. Factors identified in the first 2 days of admission associated with a length of stay more than 2 days (R2 = 0.56, P < 0.0001) included pain score >5 (P = 0.034), temperature ≥38°C (P < 0.0001), white blood cell count >18 (P = 0.036), not tolerating oral diet by day 2 (P = 0.002), severe pancreatitis on imaging (P = 0.008) and readmission in the previous 30 days (P = 0.035). Using these criteria, 57% of all admissions and 87% of admissions greater than 2 days could potentially have been transferred to enhanced outpatient care at day 2 for management. This would have saved 277 inpatient bed-days and an estimated $122 771 over the 9-month study period. A significant proportion of patients admitted with mild AP, who stay longer than 2 days in hospital, could potentially be identified and discharged early to enhanced outpatient care.

Affiliation

Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia..

Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.. Northern Territory Medical School, Flinders University, Darwin, Northern Territory, Australia..

Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia..

Citation

ANZ J Surg . 2018 Dec;88(12):1333-1336. doi: 10.1111/ans.14710. Epub 2018 Jul 8.

OrcId

0000-0002-8095-1329

0000-0002-8213-0612

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/29984528/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/7030

Subject

acute pancreatitis

outpatient care

patient discharge

Title

Early discharge of patients with acute pancreatitis to enhanced outpatient care.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Kumar, Vineeth V Treacy, P John Li, Minghao Dharmawardane, Anoj
Publication Date	2018-07-08
Abstract	Acute pancreatitis (AP) is a common cause for hospital admission, but some patients have a prolonged stay. The aim of this study was to identify patients with mild AP who had a prolonged hospital stay, who potentially could be discharged at day 2 to enhanced outpatient care. Data was retrospectively collected on all patients admitted to the Royal Darwin Hospital between May 2016 and February 2017 with a diagnosis of mild AP to identify factors that may safely predict early discharge to enhanced outpatient care. Of 115 admissions, 62% were male, 50% indigenous and alcohol was causative in 53%. A total of 75 (65%) patients stayed more than 2 days and used 342 bed-days. Factors identified in the first 2 days of admission associated with a length of stay more than 2 days (R2 = 0.56, P < 0.0001) included pain score >5 (P = 0.034), temperature ≥38°C (P < 0.0001), white blood cell count >18 (P = 0.036), not tolerating oral diet by day 2 (P = 0.002), severe pancreatitis on imaging (P = 0.008) and readmission in the previous 30 days (P = 0.035). Using these criteria, 57% of all admissions and 87% of admissions greater than 2 days could potentially have been transferred to enhanced outpatient care at day 2 for management. This would have saved 277 inpatient bed-days and an estimated $122 771 over the 9-month study period. A significant proportion of patients admitted with mild AP, who stay longer than 2 days in hospital, could potentially be identified and discharged early to enhanced outpatient care.
Affiliation	Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.. Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.. Northern Territory Medical School, Flinders University, Darwin, Northern Territory, Australia.. Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.. Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Citation	ANZ J Surg . 2018 Dec;88(12):1333-1336. doi: 10.1111/ans.14710. Epub 2018 Jul 8.
OrcId	0000-0002-8095-1329 0000-0002-8213-0612
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/29984528/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/7030
Subject	acute pancreatitis outpatient care patient discharge
Title	Early discharge of patients with acute pancreatitis to enhanced outpatient care.
Type of document	Journal Article
Entity Type	Publication

Early discharge of patients with acute pancreatitis to enhanced outpatient care.

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