A comparative analysis of gender and racial disparities in acute necrotizing pancreatitis outcomes: Insights from the national inpatient sample database.

BACKGROUND/

OBJECTIVES

Acute Necrotizing pancreatitis (NP), a severe form of pancreatitis, carries high morbidity and mortality, with outcomes influenced by patient demographics. While prior research highlights disparities in gastrointestinal diseases, the impact of race and gender on NP outcomes remains underexplored. This study evaluates the influence of these demographic factors on in-hospital mortality, complications, length of stay (LOS), and hospitalization costs.

METHODS

A retrospective cohort study was conducted using the National Inpatient Sample database (2018-2021) to identify adult patients with NP via ICD-10 codes. Multivariate linear and logistic regression analyses were used to assess in-hospital outcomes, including mortality, complications, LOS, and costs. Variables included demographic characteristics (e.g., race, gender), comorbidities, and illness severity. The primary outcome was in-hospital mortality, and secondary outcomes included complications and quality measures.

RESULTS

Among 118,580 NP patients, males (64.8 %) had higher in-hospital mortality (adjusted odds ratio [aOR] 1.14; 95 % CI 1.01-1.30; p = 0.04) and increased risks for acute kidney injury (aOR 1.45; p < 0.001), mechanical ventilation, and surgical necrosectomy. Females were more likely to be discharged to skilled care facilities. Black patients demonstrated lower mortality (aOR 0.78; p = 0.02) but higher risks for acute kidney injury and blood transfusions compared to Caucasians, with fewer invasive interventions like necrosectomy.

CONCLUSIONS

This study reveals significant racial and gender disparities in NP outcomes, with males and Black patients experiencing distinct risks and care patterns. Future studies incorporating clinical and laboratory data across settings are warranted to validate these findings.