Healthcare costs of recurrent acute pancreatitis hospitalizations.

BACKGROUND: Patients with severe hypertriglyceridemia (HTG) with hyperchylomicronemia (HC) are at especially high risk for recurrent acute pancreatitis (AP), a leading gastrointestinal cause of hospitalizations. OBJECTIVE: To describe the real-world frequency, cost, duration, and mortality rates of AP hospitalizations among patients with HC in the United States. METHODS: Data were derived from the Healthcare Cost and Utilization Project Nationwide Readmissions Database (2017-2021). Hospitalizations with any diagnostic code for AP were selected. Unadjusted per-person annual AP hospitalizations, costs, duration, and mortality were analyzed for patients with AP, AP+HTG, or AP+HC. Days between AP hospitalizations were calculated for patients with ≥4 hospitalizations. Regression modeling determined the impact of HC, demographics, comorbidities, and select procedures on outcomes. RESULTS: Overall, 788,715 patients had 968,359 AP hospitalizations (mean [SD]: 1.2 [0.7]). Mean (SD) annual AP hospitalization cost was $24,387 ($55,591), length of stay (LOS) 7.2 (10.9) days, and in-hospital mortality rate 3.3%; 14% had >1 AP hospitalization/y. Patients with AP+HC had 2.0 (1.6) AP hospitalizations, with an annual cost of $40,440 ($51,442) and 12.2 (13.9) hospitalization days/y, and were younger, with a 1.5% in-hospital mortality rate. The average time between hospitalizations was 48.9 to 55.9 days. HC added significantly to the cost (P < .01) and days (P < .0001) of AP hospitalizations. CONCLUSION: Patients with AP+HC hospitalizations have significantly greater acute healthcare utilization, with 67% more annual hospitalizations, 66% higher costs, and 71% higher LOS than overall patients hospitalized for AP or hospitalized for HTG-associated AP not diagnosed as chylomicronemia. Interventions targeting triglyceride reduction and addressing the risk of AP in such patients are needed.