Chronic Pancreatitis Hospitalizations in the United States, 2016-2022: Trends, Disparities, and Outcomes.

Abstract

Chronic pancreatitis (CP) imposes substantial clinical and economic burden, yet contemporary nationwide trends and disparities are incompletely characterized. We quantified national trends in CP hospitalizations, examined sociodemographic disparities, and evaluated clinical outcomes and resource utilization using the National Inpatient Sample (NIS) 2016-2022. We conducted a retrospective cohort study of adults (&#x2265;18 years) with chronic pancreatitis (CP) identified by ICD-10-CM codes (primary or secondary diagnosis) in the National Inpatient Sample (NIS), 2016-2022. We described patient and hospital characteristics and modeled temporal trends in CP-associated hospitalizations using survey-weighted logistic regression with year as a continuous variable. To contextualize temporal changes during the COVID-19 pandemic, we additionally calculated annual CP-associated hospitalization rates per 100,000 all-cause hospitalizations. estimated adjusted odds ratios (aORs) for hospitalization by race/ethnicity and key risk factors (alcohol use disorder [AUD], non-alcohol substance use disorder [SUD], psychiatric disorders, homelessness), adjusting for age, sex, Elixhauser comorbidity index, hospital characteristics, and region. We summarized in-hospital outcomes, complications, and resource utilization. We identified 15,732 CP hospitalizations (mean age 49.9 &#xb1; 14.0 years; 52.8% male). Most were White (63.7%), followed by Black (21.4%) and Hispanic (10.1%). Mean length of stay (LOS) was 4.5 &#xb1; 5.3 days, and mean total hospital charges were $48,068 &#xb1; 73904.35 . In adjusted models treating year as a continuous variable, the odds of CP-associated hospitalization decreased by approximately 8% annually (adjusted odds ratio [aOR] 0.92; 95% CI 0.90-0.94; p<0.001). Although absolute weighted counts transiently increased in 2020, rates normalized to all-cause hospitalizations continued to decline overall, decreasing from 41.9 per 100,000 hospitalizations in 2016 to 27.5 per 100,000 in 2022. After adjustment, Black patients had significantly higher odds of CP hospitalization than White patients (aOR 1.15; 95% CI 1.09,1.21; p < 0.001). Hispanic (aOR 0.75; 95% CI 0.70,0.80; p&#x202f;=&#x202f;0.0195) and Asian/Pacific Islander patients (aOR 0.48; 95% CI 0.40,0.58; p < 0.001) had substantially lower odds. Behavioral and social risk factors demonstrated strong association with CP hospitalization: AUD (aOR 5.76; 95% CI 5.48,6.064; p < 0.001), non-alcohol SUD (aOR 2.67; 95% CI 2.55,2.79; p < 0.001) and psychiatric comorbidity (aOR 1.57; 95% CI 1.50,1.65; p < 0.001) were independently associated with higher hospitalization risk. Homelessness was associated with lower odds after adjustment (aOR 0.76; 95% CI 0.64,0.90; p&#x202f;=&#x202f;0.002). Overall in-hospital mortality was low (0.3%). Complications included acute kidney injury (9.2%), venous thrombosis (2.6%), portal vein thrombosis (1.7%), and sepsis (0.7%). From 2016-2022, CP-associated hospitalization rates declined overall, although absolute hospitalization counts demonstrated a transient increase during the first pandemic year. Marked disparities persist-higher odds among Black patients and strong associations with AUD/SUD and psychiatric comorbidity. Despite low inpatient mortality, CP continues to generate significant resource use. These findings support targeted prevention (alcohol/substance use), integrated behavioral health, and equity-focused strategies to reduce avoidable hospitalizations.