Abstract

Background The aim of this study is to evaluate race-associated risk factors of acute pancreatitis (AP) in inflammatory bowel disease (IBD) patients.Methods A retrospective analysis using 2016 and 2017 National Inpatient Sample database was performed. Inclusion criteria were principal diagnosis of AP and a secondary diagnosis of IBD. Patients below 18 years of age were excluded. The primary outcome was in-hospital mortality rate and secondary outcomes included pancreatic necrosis, surgical necrosectomy, total hospitalization charges, total parenteral nutrition use, and length of stay. For the primary and secondary outcomes, adjusted odds ratios (aORs) and mean difference calculation using multivariate regression were calculated.ResultsA total of 7,060 patients with AP in IBD were identified; of which 53.5% were female. The use of Medicaid was significantly higher in blacks (39.5%), Hispanics (32.6%), and Asian/Pacific Islanders (40%) compared to whites (19.9%). Approximately 63.2% of AP patients in IBD received care at an urban teaching hospital. Pancreatic necrosis was noted to be highest in Asians or Pacific Islanders compared to whites (aOR 12.62, 95% CI 1.00-159.3, p = 0.05).ConclusionOur study shows that racial disparities exist among AP in IBD patients with pancreatic necrosis being more common in Asians and Pacific Islanders compared to whites. Identification of potential causes of these disparities is of paramount importance to expand access to healthcare.

Highlights

  • Acute pancreatitis (AP) has emerged as the most common gastrointestinal diagnosis at discharge [1]

  • Pancreatic necrosis was noted to be highest in Asians or Pacific Islanders compared to whites

  • Our study shows that racial disparities exist among acute pancreatitis (AP) in inflammatory bowel disease (IBD) patients with pancreatic necrosis being more common in Asians and Pacific Islanders compared to whites

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Summary

Introduction

Acute pancreatitis (AP) has emerged as the most common gastrointestinal diagnosis at discharge [1]. A population-based cohort study in Taiwan [6] determined the overall incidence of AP in patients with IBD to be 3.56 times higher than that of the general population. Such a finding was likely secondary to IBD itself and associated treatments [7]. A 16-year Danish nationwide followup study documented an elevated risk of AP in both forms of IBD: Crohn’s disease (CD) and ulcerative colitis (UC) [8]. The aim of this study is to evaluate race-associated risk factors of acute pancreatitis (AP) in inflammatory bowel disease (IBD) patients

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