Factors that influence follow-up for patients with chronic pancreatitis after presentation to the ed with abdominal pain

Document Type

Conference Proceeding

Publication Date


Publication Title

Am J Gastroenterol


Introduction: Chronic pancreatitis (CP) is a progressive fibroinflammatory disease resulting in a permanent structural damage in the pancreas. The incidence of CP in the US is around 4-14/100,000 with alcohol being the most common cause. CP can lead to abdominal pain, exocrine and endocrine dysfunction and cause significant impairment in quality of life. Recurrent presentations to the ED due to CP symptoms can impact healthcare expenditures and lead to challenges in treating these patients. Our study looks at factors affecting follow-up rates in clinics after presenting to the ED from abdominal pain. Methods: A retrospective single-center study was conducted at a large tertiary health care system in Detroit, MI. Patients 18 years of age and older who presented to the ED for Abd pain with CP from 2018 to 2020 were included. Data on demographics, ED dynamics, and follow-up were collected with a manual chart review. We used the social deprivation index (SDI) score associated with different zip codes to compare patients' socio-economic status (SES). Results: A total of 196 patients were included (mean age 49.6 years, SD 11.7), of which 117 (59.7%) were males and 102 (52.6%) were whites. 141 (71.9%) patients developed CP due to alcohol. Univariate analysis showed that women followed up in the clinic more than men (P = 0.027). whites followed up more than African Americans, Asian, Hispanic, and other races combined (p < 0.0001). Patients living in Wayne County lower (low-middle SDI score) followed up more than others living in the surrounding counties (high SDI score) (P = 0.049). Alcohol-induced CP patients followed up more than other etiologies (P = 0.049) and patients in lower SDI score counties followed up more than those in higher scores (P = 0.003). Patients who were arranged a primary care physician (PCP) or GI clinic follow-up on discharge from the ED followed up more than those who were hospitalized. There was no significant difference regarding follow-up rates and age, ED presentation frequency, tobacco use, narcotic use, and those that underwent imaging. Conclusion: Women, whites, and low-middle SES (lower SDI scores) followed up more than men, other races, and those with higher SES (higher SDI scores). Interestingly, regardless of the follow-up rates, ED visitations were not significant amongst groups suggesting that more complex factors account for CP patient's presentation to the ED. Further studies are needed to improve factors that affect follow-up rates and overcome any barriers.

PubMed ID

Not assigned.





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