Objectives A selective therapy for pancreatitis is total pancreatectomy and islet autotransplantation. Outcomes and geographical variability of patients who had total pancreatectomy (TP) alone or total pancreatectomy with islet autotransplantation (TPIAT) were assessed. Methods Data were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample database. Weighed univariate and multivariate analyses were performed to determine the effect of measured variables on outcomes. Results Between 2002 and 2013, there were 1006 TP and 825 TPIAT in patients with a diagnosis of chronic pancreatitis, and 1705 TP and 830 TPIAT for any diagnosis of pancreatitis. The majority of the TP and TPIAT were performed in larger urban hospitals. Costs were similar for TP and TPIAT for chronic pancreatitis but were lower for TPIAT compared with TP for any type of pancreatitis. The trend for TP and TPIAT was significant in all geographical areas during the study period. Conclusions There is an increasing trend of both TP and TPIAT. Certain groups are more likely to be offered TPIAT compared with TP alone. More data are needed to understand disparities and barriers to TPIAT, and long-term outcomes of TPIAT such as pain control and glucose intolerance need further study.
Bibliographical noteFunding Information:
Data were extracted from the Healthcare Cost and Utilization Project (HCUP; www.hcup-us.ahrq.gov) National Inpatient Sample (NIS) database, which was previously named Nationwide Inpatient Sample until the methodology to capture data was revised in 2012. The HCUP is sponsored by the Agency for Healthcare Quality and Research through a federal-state-industry partnership. The NIS database is an administrative, deidentified, and publically accessible database, which produces national estimates of hospital inpatient stays by compiling a 20% stratified sample of discharges, which is extracted from the State Inpatient Databases. This represents more than 97% of the population of the United States. The sample size of diagnoses and outcomes obtained by the NIS are representative of national outcomes.27,28 Data are captured from the hospitals from 48 States and the District of Columbia, which contribute data regardless of payer, so it also includes uninsured patients. The information is used in research and by policy makers to estimate health care utilization, access to care, quality of care, financial charges, and outcomes and for health care decision-making at the national, state, and local levels.
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- chronic pancreatitis
- health care utilization
- total pancreatectomy
- total pancreatectomy with islet autotransplantation