Background: Acute pancreatitis is a common gastrointestinal condition associated with significant morbidity and healthcare utilization. Hospital at Home (HaH) programs have emerged as an alternative to traditional brick-and-mortar (B&M) hospitalization, offering hospital-level care in the home setting. While HaH has demonstrated feasibility for various conditions, clinical characteristics and outcomes for pancreatitis patients managed by HaH have not been published. This study aimed to compare demographic, clinical, and outcome measures between patients with pancreatitis managed in HaH to those treated in a conventional hospital setting.
Methods: We conducted a retrospective cohort study of patients admitted for pancreatitis at Mayo Clinic from October 2020 to October 2024. Forty unique HaH patients were identified, and a 2:1 age- and sex-matched cohort of B&M patients was selected. Data collected included demographics, pancreatitis etiology, severity markers, comorbidities, and outcomes: length of stay (LOS), pancreatitis-related procedures, 7-day and 30-day readmissions, 30-day mortality, and 30-day emergency department (ED) visits. Continuous variables were summarized using medians and ranges; categorical variables as counts and percentages. Between-group comparisons employed Wilcoxon rank sum and Fisher’s exact tests. Regression models assessed differences in LOS and binary outcomes, with multivariable adjustment for systemic inflammatory response syndrome (SIRS) where feasible. Statistical significance was set at P< 0.05.
Results: HaH patients were more likely to have idiopathic pancreatitis (42.5% vs 15.0%, P=0.001), whereas B&M patients had higher rates of alcoholic pancreatitis (31.2% vs 12.5%, P=0.027) and gallstone pancreatitis (35.0% vs 7.5%, P< 0.001). B&M cohort had more frequent SIRS on admission (33.8% vs 7.5%, P=0.002). Ranson’s criteria at 48 hours differed significantly, with most B&M patients scoring 0 and over half of HaH patients scoring 2 (P< 0.001). No significant differences were observed for pancreatitis-related procedures, 7-day or 30-day readmissions, or 30-day mortality. However, HaH patients had a significantly longer LOS, 5 days in HaH vs 3 days in B&M (unadjusted P=0.006; adjusted for pancreatitis severity (presence of SIRS) (P=0.002). Conversely, B&M cohort had more 30-day ED visits (17.5% vs 0%, P=0.005).
Conclusions: HaH is a viable alternative to traditional hospitalization for acute pancreatitis, with comparable rates of readmission, pancreatitis related procedures, and mortality. Although HaH patients experienced longer LOS, they did not have any 30 day ED visit. These findings suggest acute pancreatitis can safely and effectively be managed at HaH.