P0008 - Impact of Ethnicity on the Outcomes of Acute Pancreatitis: Insights From US National Inpatient Sample Database

Sunday, October 22, 2023

3:30 PM – 7:00 PM PT

Location: Exhibit Hall

Presenting Author(s)

AJ

Ali Jaan, MD (he/him/his)

Rochester General Hospital
Rochester, NY

Ali Jaan, MD¹, Umer Farooq, MD¹, Sheza Malik, MD¹, Ammad Chaudhary, MD², Faisal Inayat, MBBS³, Uzair Chatha, MD⁴, Ahmad Khan, MD⁵, Byron Cryer, MD⁶, Sultan Mahmood, MD⁷
¹Rochester General Hospital, Rochester, NY; ²Henry Ford Hospital, Detroit, MI; ³Allama Iqbal Medical College, Lahore, Punjab, Pakistan; ⁴Lahore Medical and Dental College, Overland Park, KS; ⁵Case Western Reserve/UHCMC, Cleveland, OH; ⁶Baylor University Medical Center, Dallas, TX; ⁷Beth Israel Deaconess Medical Center, Boston, MA

Introduction: Epidemiological studies using administrative or retrospective data have highlighted racial differences in the susceptibility and progression of pancreatitis. However, limited research has been conducted to investigate the impact of race on the outcome of acute pancreatitis (AP).

Methods: Using the 2017-2020 National Inpatient Sample (NIS) database and the International Classification of Diseases, Tenth Revision, Clinical Modifications (ICD-10- CM) codes, we identified adult patients (aged ≥18 years) who were admitted with a principal diagnosis of AP. Using Whites as the reference category, we compared the outcomes of AP in African Americans, Hispanics, and Asians. Multivariate logistic regression models were used to compare the different races.

Results: We reviewed 219,835 admissions for AP. After adjusting for confounding variables, we found that African Americans had the lowest mortality rates (aOR 0.76, P< 0.01) when compared to Whites (Table 1). Additionally, African Americans had the lowest odds of septic shock (aOR 0.53, P< 0.01), acute respiratory distress syndrome (ARDS) (aOR 0.64, P< 0.01), need for mechanical ventilation (aOR 0.53, P< 0.01), and intensive care unit (ICU) admission (aOR 0.54, P< 0.01) compared to White patients. Furthermore, African Americans had shorter lengths of hospital stay (adjusted mean difference [aMD] 0.54, P< 0.01) and incurred lower average hospitalization charges (aMD -$6,844, P< 0.01) than Whites. In contrast, the Hispanic population demonstrated the lowest odds of developing acute kidney injury (AKI) (aOR 0.93, P< 0.01), portal venous thrombosis (aOR 0.51, P< 0.01), and the need for pancreatic necrosectomy (aOR 0.67, P< 0.01).

Discussion: Our study found notable racial disparities in the outcomes of AP. African Americans demonstrated lower mortality rates, lower odds of critical complications, shorter hospital stays, and lower hospitalization charges than Caucasians. These findings warrant further investigation of racial differences to achieve equitable healthcare outcomes.

Acute pancreatitis +Age >=18: (n= 219,835)
Outcomes	Race
	White (62.3%)		African American (16.7%)		Hispanic (12.8%)		Asian (2.1%)
	*aOR (95% CI)	P-value	*aOR (95% CI)	P-value	*aOR (95% CI)	P-value	*aOR (95% CI)	P-value
Mortality, %	Reference		0.76 (0.64 – 0.91)	< 0.01	0.86 (0.72 – 1.04)	0.13	0.88 (0.61 – 1.27)	0.50
Septic shock, %	Reference		0.53 (0.42 – 0.65)	< 0.01	0.90 (0.73 – 1.10)	0.31	1.15 (0.78 – 1.70)	0.49
Paralytic ileus, %	Reference		0.75 (0.56 – 0.99)	0.05	0.77 (0.57 – 1.06)	0.11	0.89 (0.46 – 1.73)	0.74
AKI, %	Reference		1.28 (1.24 – 1.34)	< 0.01	0.93 (0.89 – 0.98)	0.01	1.08 (0.98 – 1.19)	0.11
Portal venous thrombosis, %	Reference		0.57 (0.50 – 0.65)	< 0.01	0.51 (0.44 – 0.60)	< 0.01	0.68 (0.50 – 0.92)	0.01
ARDS, %	Reference		0.64 (0.46 – 0.89)	0.01	1.08 (0.79 – 1.49)	0.62	1.73 (0.96 – 3.12)	0.07
Mechanical ventilation, %	Reference		0.53 (0.47 – 0.60)	< 0.01	0.76 (0.67 – 0.87)	< 0.01	1.03 (0.80 – 1.33)	0.81
Requiring ICU admission, %	Reference		0.54 (0.48 – 0.61)	< 0.01	0.77 (0.68 – 0.87)	< 0.01	1.05 (0.83 – 1.34)	0.68
Pancreatic necrosectomy, %	Reference		0.68 (0.57 – 0.82)	< 0.01	0.67 (0.54 – 0.82)	< 0.01	1.03 (0.76 – 1.42)	0.84
*Adjusted Mean Difference (95% CI)
Length of hospital stay, days	Reference		-0.54 (-0.60 – -0.48)	< 0.01	-0.23 (-0.30 – -0.18)	< 0.01	0.12 (-0.07 – 0.30)	0.21
Total hospitalization charges, mean, USD	Reference		-6,844 (-7,780 – -5,907)	< 0.01	10,512 (9,109 – 11,914)	< 0.01	13,260 (9,810 – 16,711)	< 0.01

Table: Table 1: Unadjusted and adjusted outcomes of acute pancreatitis among different racial groups. *Adjusted for age, insurance status, sex, Charlson index, hospital bed size, hospital location, teaching status, ESRD, alcohol abuse, and obesity.
CI means confidence interval. Abbreviations- ARDS: Acute respiratory distress syndrome; AKI: Acute kidney injury; ICU: Intensive care unit; ESRD: End-stage renal disease.

Disclosures:

Ali Jaan indicated no relevant financial relationships.

Umer Farooq indicated no relevant financial relationships.

Sheza Malik indicated no relevant financial relationships.

Ammad Chaudhary indicated no relevant financial relationships.

Faisal Inayat indicated no relevant financial relationships.

Uzair Chatha indicated no relevant financial relationships.

Ahmad Khan indicated no relevant financial relationships.

Byron Cryer indicated no relevant financial relationships.

Sultan Mahmood indicated no relevant financial relationships.

Ali Jaan, MD¹, Umer Farooq, MD¹, Sheza Malik, MD¹, Ammad Chaudhary, MD², Faisal Inayat, MBBS³, Uzair Chatha, MD⁴, Ahmad Khan, MD⁵, Byron Cryer, MD⁶, Sultan Mahmood, MD⁷. P0008 - Impact of Ethnicity on the Outcomes of Acute Pancreatitis: Insights From US National Inpatient Sample Database, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.