This analysis used the National Inpatient Sample (NIS) covering 2016–2022 to quantify the burden of infections among adults hospitalized with acute pancreatitis (AP) and to evaluate their association with in-hospital outcomes. The authors report results for 2,467,233 AP hospitalizations and focused on how different infection types influenced mortality and other clinical complications.
Hospitalized adult patients with AP were identified through ICD-10 codes in the NIS database for the period 2016 to 2022. Patients with missing demographic or mortality data were excluded. Remaining patients were stratified by documented infection type. The analysis included demographic data, presumed AP etiology, comorbid conditions, and prespecified clinical outcomes.
The primary outcome was in-hospital mortality stratified by infection type. Secondary outcomes included sepsis, shock, acute kidney injury (AKI), intensive care unit (ICU) admission, deep vein thrombosis (DVT), pulmonary embolism (PE), and portal vein thrombosis (PVT).
Among the 2,467,233 AP admissions identified, 392,255 patients (15.9%) developed infectious complications during the index hospitalization. The distribution of infection types was:
These proportions reflect the relative frequency of coded infections among AP inpatients in the NIS sample.
Mortality differed substantially across infection categories. Reported in-hospital mortality rates by infection type were:
Overall, AP patients with any documented infection had higher in-hospital mortality compared with those without infections.
The authors evaluated several secondary outcomes to characterize morbidity associated with infectious complications in AP admissions. These outcomes included sepsis, shock, AKI, ICU admission, DVT, PE, and PVT. The abstract reports that infectious complications were associated with worse in-hospital outcomes but does not provide detailed rates or adjusted effect estimates for each secondary outcome in the abstract.
After adjustment for confounding factors, patients with infectious complications experienced significantly higher in-hospital mortality than those without infections: 6.7% versus 1.6% (p < 0.001). This adjusted comparison indicates that infections confer an increased risk of death during the hospitalization for AP in this nationwide sample.
The findings emphasize that infectious complications in AP are not uncommon (affecting roughly one in six admissions) and are associated with clinically important increases in mortality and morbidity. In particular, SBP and pneumonia were associated with the highest in-hospital mortality rates, suggesting these conditions should prompt heightened diagnostic vigilance and aggressive management when present in patients with AP.
Early recognition, prompt diagnostic evaluation, and timely institution of appropriate therapy for infective processes in AP may be important strategies to mitigate risk. The abstract highlights the need for awareness of the spectrum of infections that may complicate AP, from common urinary tract infection to less frequent but higher-risk diagnoses such as SBP.
The abstract provides key prevalence and mortality figures but does not report several details that would be relevant for clinical interpretation. The following items were not reported in the abstract and therefore cannot be inferred from this source:
Because these elements are not presented in the abstract, readers should consult the full article for expanded methods, statistical models, and comprehensive results if needed.