S139 Sex-Related Disparities Observed in Acute Pancreatitis-Associated ARF/ARDS Mortality: A CDC WONDER Analysis (2018 to 2023)

Introduction: Acute pancreatitis complicated by acute respiratory failure (ARF) or acute respiratory distress syndrome (ARDS) is associated with high mortality. However, recent population-level trends and sex-related disparities in mortality from this condition remain poorly characterized, particularly in the context of the COVID-19 pandemic. Methods: We conducted a retrospective analysis of age-adjusted mortality rates (AAMRs) for acute pancreatitis-associated ARF/ARDS in the United States using CDC WONDER data from 2018 to 2023. Trends were evaluated for the total population and stratified by sex. Both linear and segmented regression models were applied to assess annual percent change (APC) and to identify inflection points in mortality trends. Results: Six years of data comprising 6,881 deaths related to ARF/ARDS in the setting of acute pancreatitis were analyzed. For the overall population, the AAMR was 0.47 per 100,000, with a significant upward trend (APC +5.7%, P = 0.042). Mortality rates remained stable at 0.4 per 100,000 during 2018 to 2019, then increased to 0.5 per 100,000 from 2020 to 2023, with a clear inflection point identified in 2020. Men exhibited higher mortality (AAMR 0.60 per 100,000) than women (AAMR 0.37 per 100,000), representing a 62% disparity. Men showed a more variable trajectory, with a peak in 2020 to 2021 (0.7 per 100,000) and a subsequent decline, while women demonstrated a consistent stepwise increase from 0.3 to 0.4 per 100,000 (APC +7.6%, P = 0.042). Segmented regression confirmed 2020 as a significant breakpoint across all groups. Conclusion: Men exhibit 62% higher mortality rates than women (0.60 vs 0.37 per 100,000). Mortality from acute pancreatitis-associated ARF/ARDS increased abruptly in 2020 and remained elevated, with pronounced sex-based disparities—particularly a greater relative increase among women. These findings highlight 2020 as a critical transition year, likely reflecting pandemic-related healthcare disruptions, and underscore the need for targeted interventions and continued surveillance of at-risk populations.