Measures associated with hospital readmission of pancreatitis patients

Pancreatic necrosis volume (PNV) on CT imaging was recently revealed to have a significant association with hospital readmission after initial treatment for pancreatitis. 

An analysis of 167 patients with necrotizing pancreatitis examined the readmission and reintervention rates relative to PNV and found that more than half of patients with increased volumes on contrast-enhanced CT were readmitted after discharge. Beyond readmission, 32.9% of these patients required additional invasive interventions. 

“Readmission [also] imposes a significant burden on the healthcare system and has been identified as a target for healthcare quality improvement. Thus, understanding risk factors for readmission and reintervention after discharge in patients with NP has important clinical significance,” corresponding author Yin Zhu, from the Department of Gastroenterology, Digestive Disease Hospital with The First Affiliated Hospital of Nanchang University in China, and co-authors shared.

Prior studies have linked necrotizing pancreatitis with increased mortality rates, but none have provided a means to reliably and objectively quantify organ values in a way that could aid providers in distinguishing low- and high-risk patients prior to hospital discharge. To examine the value of PNV in predicting the need for readmission and additional interventions, experts conducted a retrospective analysis of the contrast-enhanced CT scans that occurred one week prior to discharge of their NP patient cohort. 

Through this, they found that PNVs were significantly higher in patients that were re-hospitalized. Specifically, volumes greater than 620 cm3 were found to be independently associated with readmission, as were CT severity index scores higher than 7 points. Factors found to be associated with the need for additional intervention were the same PNV and CT severity score measures, in addition to stent or drainage tube placement at discharge and parenchymal necrosis on imaging. 

Discussing the current and future value that PNV measurements can provide clinicians in care management, the experts wrote:  

“The PNV is a parameter that can be calculated routinely and prospectively in CT examinations of AP patients; indeed, in the near future, it could be obtained automatically with the help of software or artificial intelligence. The value of this technique for clinical application is worthy of further exploration.” 

The detailed work can be viewed in the European Journal of Radiology

More on imaging of the pancreas:

Advanced MRI technique significantly improves radiologists’ ability to image the pancreas

AI spots pancreatic cancer in its earliest stages

CT imaging features forecast outlook for patients with aggressive pancreatic cancer

Radiology reporting template bolsters follow-up care for incidental pancreatic findings

Reference: 

Qian Liao, Ling Ding, Xin Xu, Chen Yu, Feng Deng, Huifang Xiong, Wenhua He, Liang Xia, Xianjun Zeng, Nonghua Lu, Yin Zhu. Pancreatic necrosis volume for predicting readmission and reintervention in acute necrotizing pancreatitis. European Journal of Radiology, 2022. 

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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