Early versus delayed necrosectomy in pancreatic necrosis: A population-based cohort study on readmission, healthcare utilization, and in-hospital mortality

Table 1 Clinical characteristics of all patients (index hospitalizations) who underwent pancreatic necrosectomy with a primary diagnosis of pancreatic necrosis, n (%)

Factor	Unmatched patients			Matched patients
	Within 48 hours (cases)	After 48 hours (controls)	P value	Within 48 hours (cases)	After 48 hours (controls)	P value
Total patients	420	889		349	375
Length of stay, median (IQR)	6.0 (3.0, 10.0)	23.0 (12.0, 42.0)	< 0.001	6.0 (4.0, 11.0)	16.0 (9.0, 31.0)	< 0.001
Total hospital charges in USD, median (IQR)	51773.0 (28907.0, 92300.0)	196571.0 (89244.0, 408072.0)	< 0.001	52202.0 (29417.0, 101413.0)	147418.0 (73243.5, 316993.0)	< 0.001
30-day readmission	35 (8.3)	34 (3.8)	< 0.001	30 (8.6)	18 (4.8)	0.040
Age in years at admission, median (IQR)	55.0 (41.0, 66.0)	52.0 (39.0, 64.0)	0.080	55.0 (42.0, 66.0)	55.0 (39.0, 64.0)	0.13
Age groups (years)			0.068			0.061
18-34	51 (12.1)	144 (16.2)		38 (10.9)	57 (15.2)
35-49	113 (26.9)	241 (27.1)		91 (26.1)	100 (26.7)
50-64	134 (31.9)	301 (33.9)		117 (33.5)	138 (36.8)
≥ 65	122 (29.0)	203 (22.8)		103 (29.5)	80 (21.3)
Elixhauser comorbidity index score			< 0.001			0.32
0	32 (7.6)	18 (2.0)		20 (5.7)	18 (4.8)
1	37 (8.8)	46 (5.2)		24 (6.9)	40 (10.7)
2	71 (16.9)	91 (10.2)		65 (18.6)	65 (17.3)
≥ 3	280 (66.7)	734 (82.6)		240 (68.8)	252 (67.2)
Primary payer			0.65			0.37
Medicare	129 (33.9)	260 (30.3)		112 (35.8)	109 (30.4)
Medicaid	73 (19.2)	166 (19.4)		57 (18.2)	70 (19.6)
Private	158 (41.5)	381 (44.5)		127 (40.6)	151 (42.2)
Other	21 (5.5)	50 (5.8)		17 (5.4)	28 (7.8)
Median household income national quartile for patient ZIP Code			0.28			0.53
1st (0-25th)	105 (25.5)	197 (22.3)		88 (25.7)	88 (23.6)
2nd (26th-50th)	114 (27.7)	256 (28.9)		94 (27.4)	107 (28.7)
3rd (51st-75th)	109 (26.5)	271 (30.6)		87 (25.4)	109 (29.2)
4th (76th-100th)	84 (20.4)	161 (18.2)		74 (21.6)	69 (18.5)
Disposition of patient (uniform)			< 0.001			0.12
Routine	264 (62.9)	396 (44.6)		211 (60.5)	214 (57.2)
Transfer to SNF, STH, ICF, and another facility, or AMA	57 (13.6)	182 (20.5)		47 (13.5)	60 (16.0)
HHC	94 (22.4)	259 (29.2)		87 (24.9)	84 (22.5)

STH: short-term hospital; SNF: Skilled nursing facility; ICF: Intermediate care facility; HHC: Home health care; AMA: Against medical advice.

Table 2 Distribution of Elixhauser comorbidities among all patients (index hospitalizations) who underwent pancreatic necrosectomy with a primary diagnosis of pancreatic necrosis, n (%)

Factor	Unmatched patients			Matched patients
	Within 48 hours (cases)	After 48 hours (controls)	P value	Within 48 hours (cases)	After 48 hours (controls)	P value
Total patients	420	889		349	375
Congestive heart failure	35 (8.3)	81 (9.1)	0.64	30 (8.6)	29 (7.7)	0.67
Cardiac arrhythmias	55 (13.1)	287 (32.3)	< 0.001	48 (13.8)	58 (15.5)	0.51
Uncomplicated hypertension	230 (54.8)	458 (51.5)	0.27	194 (55.6)	200 (53.3)	0.54
Chronic pulmonary diseases	81 (19.3)	135 (15.2)	0.062	72 (20.6)	59 (15.7)	0.087
Uncomplicated diabetes	70 (16.7)	119 (13.4)	0.11	58 (16.6)	53 (14.1)	0.35
Complicated diabetes	66 (15.7)	170 (19.1)	0.13	55 (15.8)	64 (17.1)	0.64
Hypothyroidism	19 (4.5)	83 (9.3)	0.002	17 (4.9)	27 (7.2)	0.19
Renal failure	29 (6.9)	66 (7.4)	0.74	24 (6.9)	25 (6.7)	0.91
Liver disease	69 (16.4)	227 (25.5)	< 0.001	54 (15.5)	55 (14.7)	0.76
Coagulopathy	31 (7.4)	136 (15.3)	< 0.001	20 (5.7)	25 (6.7)	0.60
Obesity	60 (14.3)	204 (22.9)	< 0.001	43 (12.3)	43 (11.5)	0.72
Weight loss	118 (28.1)	444 (49.9)	< 0.001	108 (30.9)	124 (33.1)	0.54
Fluid and electrolyte disorder	227 (54.0)	634 (71.3)	<0.001	215 (61.6)	211 (56.3)	0.14
Iron-deficiency anemia	33 (7.9)	67 (7.5)	0.84	29 (8.3)	24 (6.4)	0.32
Alcohol abuse	110 (26.2)	271 (30.5)	0.11	97 (27.8)	108 (28.8)	0.76
Drug abuse	21 (5.0)	78 (8.8)	0.016	15 (4.3)	26 (6.9)	0.13
Depression	72 (17.1)	163 (18.3)	0.60	59 (16.9)	73 (19.5)	0.37
Complicated hypertension	32 (7.6)	86 (9.7)	0.23	26 (7.4)	27 (7.2)	0.90

Table 3 Clinical outcomes of all patients (index hospitalizations) who underwent pancreatic necrosectomy with a primary diagnosis of pancreatic necrosis, n (%)

Factor	Unmatched patients			Matched patients
	Within 48 hours (cases)	After 48 hours (controls)	P value	Within 48 hours (cases)	After 48 hours (controls)	P value
Total patients	420	889		349	375
Mechanical ventilation	14 (3.3)	155 (17.4)	< 0.001	< 10	41 (10.9)	< 0.001
Septic shock	38 (9.0)	239 (26.9)	< 0.001	28 (8.0)	73 (19.5)	< 0.001
Portal venous thrombosis	35 (8.3)	71 (8.0)	0.83	30 (8.6)	27 (7.2)	0.49
ICU-level admission	< 10	145 (16.3)	< 0.001	< 10	37 (9.9)	< 0.001
Acute kidney injury	64 (15.2)	330 (37.1)	< 0.001	54 (15.5)	114 (30.4)	< 0.001
New RRT during admission	15 (3.6)	43 (4.8)	0.30	13 (3.7)	< 10	0.20
Died during hospitalization	< 10	50 (5.6)	< 0.001	< 10	16 (4.3)	0.010

ICU: Intensive care unit; RRT: Renal replacement therapy. NOTE: According to the Healthcare Cost and Utilization Project Data Use Agreement, any individual table cell counts of ≤ 10 have been masked to ensure privacy and compliance. In such instances, data are designated as < 10.