Assessment of the July effect in post-endoscopic retrograde cholangiopancreatography pancreatitis:Nationwide Inpatient Sample

• 作者: Allison R Schulman Christopher C Thompson Marwan S Abougergi
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: 胰腺炎 学术训练 内视镜后退 cholangiopancreatography 内视镜检查法 7 月效果
• 年，卷（期）: 2017,（7）
• 页码范围: 296-303
• 页数: 8页
• 分类号: R576

摘要

AIM To assess incidence of post-endoscopic retrograde cholangiopancreatography（post-ERCP） pancreatitis in the early（July/August/September） vs the late（April/May/June） academic year and evaluate in-hospital mortality,length of stay（LOS）,and total hospitalization charge between these time periods.METHODS This was a retrospective cohort study using the 2012 Nationwide Inpatient Sample（NIS）.Patients with International Classification of Diseases,9th Revision,Clinical Modification（ICD-9 CM） procedure codes for ERCP were included.Patients were excluded from the study if they had an ICD-9 CM code for a principal diagnosis of acute pancreatitis,if the ERCP was performed before or on the day of admission or if they were admitted to non-teaching hospitals.Post-ERCP pancreatitis was defined as an ICD-9 CM code for a secondary diagnosis of acute pancreatitis in patients who received an ERCP as delineated above.ERCPs performed during the months of July,August and September was compared to those performed in April,May and June in academic hospitals.ERCPs performed at academic hospitals during the early vs late year were compared.Primary outcome was incidence of post-ERCPpancreatitis.Secondary outcomes included in-hospital mortality,length LOS,and total hospitalization charge.Proportions were compared using fisher’s exact test and continuous variables using student t-test.Multivariable regression was performed.RESULTS From the 36480032 hospitalizations in 2012 in the United States,6248 were included in the study（3065 in July/August/September and 3183 in April/May/June） in the 2012 academic year.Compared with patients admitted in July/August/September,patients admitted in April/May/June had no statistical difference in all variables including mean age,percent female,Charleston comorbidity index,race,median income,and hospital characteristics including region,bed size,and location.Incidence of post-ERCP pancreatitis in early vs late academic year were not statistically significant（OR = 1.03,95%CI:0.