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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Gastroenterology 1/2014

Mortality following acute pancreatitis: social deprivation, hospital size and time of admission: record linkage study

Zeitschrift:
BMC Gastroenterology > Ausgabe 1/2014
Autoren:
Stephen E Roberts, Kymberley Thorne, P Adrian Evans, Ashley Akbari, David G Samuel, John G Williams
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-230X-14-153) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

SER initiated, designed and led the study, obtained funding, supervised the analyses, interpreted the study findings, wrote and edited the manuscript. KT reviewed the literature, analysed the data, interpreted the study findings and edited the manuscript. AA programmed and analysed the data, interpreted the study findings and reviewed the manuscript. PAE interpreted the study findings and reviewed the manuscript. JGW and DGS advised on study design, interpreted the study findings and edited the manuscript. All authors approved the final version of the article, including the authorship list.

Abstract

Background

Very little is known about whether mortality following acute pancreatitis may be influenced by the following five factors: social deprivation, week day of admission, recruitment of junior doctors in August each year, European Working Time Directives (EWTDs) for junior doctors’ working hours and hospital size. The aim of this study was to establish how mortality following acute pancreatitis may be influenced by these five factors in a large cohort study.

Methods

Systematic record linkage of inpatient, mortality and primary care data for 10 589 cases of acute pancreatitis in Wales, UK (population 3.0 million), from 1999 to 2010. The main study outcome measure was mortality at 60 days following the date of admission.

Results

Mortality was 6.4% at 60 days. There was no significant variation in mortality according to social deprivation or the week day of admission. There was also no significant variation according to calendar month for acute pancreatitis overall or for gallstone aetiology, but for alcoholic acute pancreatitis, mortality was increased significantly by 93% for admissions during the months of August and September and 102% from August to October when compared with all other calendar months. Mortality was increased significantly for alcoholic aetiology in August 2004, the official month that the first EWTD was implemented, but there were no other increases following the first or second EWTDs. There were also indications of increased mortality in large hospitals when compared with small hospitals, for acute pancreatitis overall and for gallstone aetiology but not for alcoholic acute pancreatitis, although these increases in mortality were of quite marginal significance.

Conclusions

Although we found some evidence of increased mortality for patients admitted with alcoholic acute pancreatitis during August to October, in August 2004, and in large hospitals for acute pancreatitis overall and for gallstone aetiology, the study factors had limited impact on mortality following acute pancreatitis and no significant impact when adjusted for multiple comparisons.
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