Comparative outcomes and characteristics of biliary, alcoholic and drug-induced pancreatitis based on the National Inpatient Sample (2016-2021).

BACKGROUND

Pancreatitis outcomes vary significantly depending on etiology. We compared biliary, alcoholic and drug-induced pancreatitis, focusing on mortality, complications and healthcare resource utilization to inform etiology-specific management strategies.

METHODS

A nationwide retrospective analysis was conducted using the National Inpatient Sample (NIS) database from 2016-2021. Patients with biliary, alcoholic and drug-induced pancreatitis were identified using International Classification of Diseases, 10th Revision (ICD-10) codes. Logistic regression models were used to compare mortality, complications and healthcare utilization, with biliary pancreatitis as the reference. Adjusted odds ratios (aORs) and regression coefficients were calculated.

RESULTS

A total of 287,050 biliary, 451,730 alcoholic, and 27,465 drug-induced pancreatitis hospitalizations were identified. Patients with alcoholic pancreatitis were younger and predominantly male, while those with drug-induced pancreatitis had higher comorbidity burdens, including diabetes, dyslipidemia and hypertension. Mortality was higher in alcoholic pancreatitis (aOR 1.19, 95% confidence interval [CI] 1.06-1.41; P=0.05), whereas drug-induced pancreatitis showed no significant difference. Alcoholic pancreatitis was associated with greater odds of pseudocyst formation (aOR 3.54, 95%CI 3.32-3.79), bleeding (aOR 1.52, 95%CI 1.41-1.63), and mechanical ventilation (aOR 2.06, 95%CI 1.84-2.31), all with P<0.001. In contrast, drug-induced pancreatitis was linked to lower odds of bleeding (aOR 0.69, 95%CI 0.57-0.84; P<0.001) and percutaneous drainage (aOR 0.23, 95%CI 0.09-0.63; P=0.004). Both alcoholic and drug-induced pancreatitis had shorter hospital stays and lower total charges compared with biliary pancreatitis.

CONCLUSIONS

Alcoholic pancreatitis is associated with higher mortality and complication rates, while drug-induced pancreatitis demonstrates fewer complications but greater comorbidity. These findings highlight the importance of etiology-based management in optimizing pancreatitis outcomes.