Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10232
Title: Early discharge of patients with acute pancreatitis to enhanced outpatient care.
Authors: Kumar, Vineeth V
Treacy, P John
Li, Minghao
Dharmawardane, Anoj
Affiliation: Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia.. Northern Territory Medical School, Flinders University, Darwin, Northern Territory, Australia..
Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Department of Surgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia..
Issue Date: 8-Jul-2018
Citation: ANZ journal of surgery 2018-07-08
Abstract: Acute pancreatitis (AP) is a common cause for hospital admission, but some patients have a prolonged stay. The aim of this study was to identify patients with mild AP who had a prolonged hospital stay, who potentially could be discharged at day 2 to enhanced outpatient care. Data was retrospectively collected on all patients admitted to the Royal Darwin Hospital between May 2016 and February 2017 with a diagnosis of mild AP to identify factors that may safely predict early discharge to enhanced outpatient care. Of 115 admissions, 62% were male, 50% indigenous and alcohol was causative in 53%. A total of 75 (65%) patients stayed more than 2 days and used 342 bed-days. Factors identified in the first 2 days of admission associated with a length of stay more than 2 days (R2  = 0.56, P < 0.0001) included pain score >5 (P = 0.034), temperature ≥38°C (P < 0.0001), white blood cell count >18 (P = 0.036), not tolerating oral diet by day 2 (P = 0.002), severe pancreatitis on imaging (P = 0.008) and readmission in the previous 30 days (P = 0.035). Using these criteria, 57% of all admissions and 87% of admissions greater than 2 days could potentially have been transferred to enhanced outpatient care at day 2 for management. This would have saved 277 inpatient bed-days and an estimated $122 771 over the 9-month study period. A significant proportion of patients admitted with mild AP, who stay longer than 2 days in hospital, could potentially be identified and discharged early to enhanced outpatient care.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10232
DOI: 10.1111/ans.14710
ORCID: http://orcid.org/0000-0002-8095-1329
http://orcid.org/0000-0002-8213-0612
Type: Journal Article
Subjects: acute pancreatitis
outpatient care
patient discharge
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