Morbidity and Mortality Trends of Pancreatitis: An Observational Study

Nicholas E Ingraham, Samantha King, Jennifer Proper, Lianne Siegel, Emily J Zolfaghari, Thomas A Murray, Victor Vakayil, Adam Sheka, Ruoying Feng, Gabriel Guzman, Samit Sunny Roy, Dhannanjay Muddappa, Michael G Usher, Jeffrey G Chipman, Christopher J Tignanelli, Kathryn M Pendleton

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background: Pancreatitis accounts for more than $2.5 billion of healthcare costs and remains the most common gastrointestinal (GI) admission. Few contemporary studies have assessed temporal trends of incidence, complications, management, and outcomes for acute pancreatitis in hospitalized patients at the national level. Methods: We used data from one of the largest hospital-based databases available in the United States, the Healthcare Cost and Utilization Project's (HCUP) State Inpatient Database, from 10 states between 2008 and 2015. We included patients with a diagnosis of acute pancreatitis (ICD-9 CM 577.0). Patient- and hospital-level data were used to estimate incidence and inpatient mortality rates. Results: From 80,736,256 hospitalizations, 929,914 (1.15%) cases of acute pancreatitis were identified, 186,226 (20.2%) of which were caused by gallbladder disease). The median age was 53 years (interquartile range [IQR], 41-67) and 50.8% were men. In-hospital mortality was 2.5% and crude mortality rates declined from 2.9% to 2.0% over the study period. Admission year remained significant after adjusting for patient demographics and comorbidities (odds ratio [OR], 0.90; 95% confidence interval [CI], 0.89-0.90; p < 0.001). Gallbladder disease was associated with decreased odds of mortality (OR, 0.60; 95% CI, 0.57-0.62). Median length of stay was four days (IQR, 2-7) and decreased over time. The rates of surgical and endoscopic interventions were highest in 2011 (peak incidence of 16.1% and 9.5%, respectively) and have been decreasing since. Surgical providers were, on average, more likely than medical providers to perform surgery in both those with and without gallbladder disease etiology (gallbladder disease OR, 7.11; 95% CI, 5.46-9.25; non-gallbladder disease OR, 20.50; 95% CI, 16.81-25.01), endoscopy (gallbladder disease OR, 1.22; 95% CI, 0.87-1.72; non-gallbladder disease OR, 1.60; 95% CI, 1.18-2.16), or both (gallbladder disease OR, 7.00; 95% CI, 5.22-9.37; non-gallbladder disease OR, 8.85; 95% CI, 5.61-13.96). Conclusions: The incidence of pancreatitis, from 2008 to 2015, has increased whereas inpatient mortality (i.e., case fatality) has decreased. Understanding temporal trends in outcomes and management along with provider, hospital, and regional variation can better identify areas for future research and collaboration in managing these patients.

Original languageEnglish (US)
Pages (from-to)1021-1030
Number of pages10
JournalSurgical infections
Issue number10
StatePublished - Dec 2021

Bibliographical note

Funding Information:
This work was supported by NIH NHLBI T32HL07741 (to N.E.I.); the Agency for Healthcare Research and Quality (AHRQ) and Patient-Centered Outcomes Research Institute (PCORI), grant K12HS026379 (to C.J.T.); the National Institutes of Health’s National Center for Advancing Translational Sciences, grant KL2TR002492 and UL1TR002494; the NIH NHLBI T32HL129956 (to J.P., L.S.); and AHRQ R01HS026732 (to M.G.U.).

Publisher Copyright:
© Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.


  • health personnel
  • minimally invasive surgical procedures
  • mortality
  • pancreatic diseases
  • pancreatitis
  • surgical procedures, operative

PubMed: MeSH publication types

  • Journal Article
  • Observational Study


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