Outcomes of Acute Pancreatitis in Hospitalized Patients With Generalized Anxiety Disorder

Pooja Saiganesh; Alexander J Kaye; Shivani J Patel; Sarah R Meyers; Anna G Mathew; Weizheng Wang

doi:10.7759/cureus.43795

Outcomes of Acute Pancreatitis in Hospitalized Patients With Generalized Anxiety Disorder

Cureus. 2023 Aug 20;15(8):e43795. doi: 10.7759/cureus.43795. eCollection 2023 Aug.

Authors

Pooja Saiganesh¹, Alexander J Kaye¹, Shivani J Patel¹, Sarah R Meyers², Anna G Mathew¹, Weizheng Wang³

Affiliations

¹ Internal Medicine, Rutgers University New Jersey Medical School, Newark, USA.
² Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, USA.
³ Gastroenterology and Hepatology, Rutgers University New Jersey Medical School, Newark, USA.

Abstract

Introduction Acute pancreatitis (AP) is a common cause of hospitalization in the United States. There is evidence that chronic stress increases the risk for more severe AP episodes. One common form of chronic stress is generalized anxiety disorder (GAD). The purpose of this research was to investigate the impact of GAD on the outcomes of adult patients admitted to the hospital with AP. Methods Utilizing the 2014 National Inpatient Sample database and International Classification of Diseases, Ninth Edition Revision (ICD) codes, AP patients were selected. Common inpatient outcomes of AP patients with and without GAD were examined. The outcomes studied were acute renal failure, acute respiratory failure, sepsis, acute deep vein thrombosis, myocardial infarction, intestinal perforation, and inpatient mortality. A multivariate logistic regression analysis was conducted to assess if GAD was an independent predictor for these outcomes. Results Among 82,156 adult patients hospitalized for AP during the 2014 year, 10,611 of them had coexisting GAD. AP patients with comorbid GAD were found to have an increased likelihood of acute renal failure (aOR = 1.19, 95% confidence interval (CI) = 1.11-1.28, p < 0.001), sepsis (aOR = 1.09, 95% CI = 1.01 -1.19, p = 0.037), acute deep vein thrombosis (aOR = 1.63, 95% CI = 1.06-2.50, p = 0.025), and inpatient mortality (aOR = 1.62, 95% C = I 1.27-2.08, p < 0.001). There was no statistically significant difference found between the two cohorts for the outcomes of myocardial infarction and intestinal perforation. Conclusion In patients hospitalized with AP, those with coexisting GAD were found to have an increased risk of developing acute renal failure, sepsis, acute deep vein thrombosis, and inpatient mortality. There may be benefits to identifying AP patients with comorbid GAD at the time of admission and monitoring them more carefully during their hospitalization to help identify early signs of complications or prevent the negative outcomes seen in this study.

Keywords: acute pancreatitis; acute renal failure; deep vein thrombosis (dvt); generalized anxiety disorder; inpatient mortality; sepsis.