S264 Potential Impact of Malnutrition on Patients Hospitalized With Pancreatic Pseudocysts: A Nationwide Analysis

Introduction: Pancreatic pseudocysts are a common complication of both acute and chronic pancreatitis and are often linked to a complicated clinical course. Despite its high prevalence in this population, malnutrition remains frequently underrecognized. This study aims to assess the association between malnutrition and in-hospital outcomes in patients diagnosed with pancreatic pseudocysts in the context of pancreatitis. Methods: A retrospective analysis of adult patients hospitalized with the diagnosis of acute and chronic pancreatitis between 2019 and 2021 was conducted using the United States Nationwide Inpatient Sample database. Using ICD codes, we identified patients with pancreatic pseudocysts and stratified them based on the presence or absence of malnutrition. We compared demographics and clinical characteristics, as well as in-hospital mortality and other secondary outcomes such as sepsis, respiratory failure, acute kidney injury, portal venous thrombosis, hemoperitoneum, abdominal compartment syndrome and length of stay. Multivariate logistic regression was used to adjust for relevant variables. Results: A total of 74,756 patients with pancreatitis were identified, of whom 7147 had a concurrent diagnosis of pancreatic pseudocyst. Patients with pancreatic pseudocyst had a longer mean length of stay (7.17 vs 4.99 days) and a higher mean total hospital charges ($76,801.59 vs $52,192.17). Malnutrition was more prevalent among patients with pancreatic pseudocyst (15.68% vs 7.37%). Additionally, in patients with pancreatic pseudocyst, malnutrition was independently associated with a higher chance of in-hospital mortality (odds ratio [OR] 5.23, P < 0.001). It was also associated with increased odds of developing sepsis (OR 2.90, P < 0.001), acute kidney injury (OR 2.12, P < 0.001), respiratory failure (OR 3.29, P < 0.001), portal venous thrombosis (OR 2.03, P < 0.001), hemoperitoneum (OR 2.42, P = 0.004), and abdominal compartment syndrome (OR 3.62, P = 0.006). Conclusion: Malnutrition is a prevalent diagnosis in patients with acute and chronic pancreatitis including those with a concurrent diagnosis of pancreatic pseudocyst. Our study showed that malnutrition is a strong and independent predictor of mortality and major in-hospital complications in patients hospitalized with the diagnosis of pancreatic pseudocyst. These findings highlight the importance of early nutritional assessment and timely intervention to reduce complications, lower healthcare utilization, and improve survival in this vulnerable patient population.