Background: Acute pancreatitis (AP) is a common cause of hospitalization in the United States. The aim of our study is to investigate the impact of gender on the outcomes of AP in adult patients hospitalized with AP.
Methods: We performed a retrospective study of adult patients with AP utilizing the 2020 Nationwide Inpatient Sample (NIS) database and International Classification of Diseases, Tenth Revision (ICD-10) codes. We compared inpatient outcomes of AP between males and females. The primary outcome was all-cause inpatient mortality. Secondary outcomes were length of stay, healthcare cost utilization, incidence of acute kidney injury (AKI), sepsis, shock and need for ICU admission. Statistical analyses were performed using STATA, version 16.1. A multivariate logistic regression analysis was conducted to assess if gender was an independent predictor for these outcomes and to adjust for any confounders.
Results: 252,595 adult patients were admitted for AP in 2020. Mean age was 50.9 years, 55.1 % of the patients were males. Majority of patients were white (63.64%). Female patients had higher prevalence of congestive heart failure (6.48% vs 5.69%, P < 0.01), chronic kidney disease (9.26% vs 8.47%, P < 0.01) and obesity (23.37% vs 17.39%, P < 0.01). Male patients had higher prevalence of liver cirrhosis (1.81% vs 1.75%, P = 0.61), type 1 diabetes mellitus (DM1) (1.32% vs 1.25%, P = 0.5), type 2 diabetes mellitus (DM2) (27.32% vs 24.68%, P < 0.01) and smoking/tobacco use (39.38% vs 29.28%, P < 0.01). Females had significantly lower likelihood of in-hospital mortality (aOR: 0.64, 95% CI: 0.51-0.82, P < 0.01), AKI (aOR 0.72, 95% CI: 0.68-0.76, P < 0.01), sepsis (aOR: 0.68, 95% CI: 0.63-0.75, P < 0.01) and shock (aOR: 0.74, 95% CI: 0.62-0.89, P < 0.01) compared to males. There was no statistically significant difference between LOS, total hospitalization charges and ICU admission between the two genders.
Conclusions: We found that females had significantly improved clinical outcomes, including lower mortality, AKI, sepsis and shock as compared to males. Male patients should receive care with great caution in order to prevent morbidity and mortality in AP. There was no statistical difference between the two genders in length of hospital stay, total hospitalization charges and ICU admission.