S39 A 2-Decade Shift in Acute Pancreatitis Mortality: Alarming Rise Among Men From 2018 to 2020

Introduction: Acute pancreatitis is a leading cause of gastrointestinal-related hospitalizations in the United States. While overall mortality has generally declined in recent decades, there is limited analysis of demographic-specific inflection points. This study evaluated trends in mortality rates of acute pancreatitis from 1999 to 2020 by age, race, and sex. Methods: We analyzed deaths attributed to acute pancreatitis as a primary cause from 1999 to 2020 in the United States utilizing CDC WONDER. Mortality rates were stratified by age, race, and sex. Age-standardized rates were used for race and sex, while crude rates were used for age groups. Trends were analyzed using Joinpoint regression (v5.20), and the mean annual percent change (APC) was calculated to assess temporal trends. Results: Mortality trends were assessed for 10-year age groups, ranging from 45 to 85+ years. There was no significant change in mortality over time for 45 to 54 years as well as 55 to 64 years. However, the 65-74 age group experienced a significant decrease in mortality with an APC of -2.8% (P < 0.05). The 75-84 age group showed a significant increase in mortality from 1999 to 2002 (APC of 4.9%, P < 0.05) followed by a significant decline from 2002 onwards (APC of -3.8%, P < 0.05). Asian patients demonstrated the largest decline in mortality rates, with an APC of -3.9% (P < 0.05) over the full period. Similarly, Blacks experienced a significant decrease in mortality (APC of -3.7%, P < 0.05) from 1999 to 2018. Whites also saw a significant reduction in mortality though at a slower rate (APC of -1.6%, P < 0.05). Among women, there was a reduction in mortality rates with an APC of -2.5% (P < 0.05) over the full period. In comparison, men experienced a significant decrease in mortality from 2008 to 2018 (APC of -3%, P < 0.05) followed by a sharp and concerning increase from 2018 to 2020 with an APC of 13.6% (P < 0.05). Conclusion: While mortality from acute pancreatitis declined across most cohorts (older adults, women, Asians, and Blacks), a striking reversal occurred among men from 2018 to 2020. This recent surge suggests a concerning shift that may reflect emerging public health challenges such as increased alcohol use, delayed care during the COVID-19 pandemic, or other unmeasured stressors. Given the narrowing window to intervene, future studies should prioritize identifying the underlying drivers of this trend to guide targeted, gender-specific prevention strategies.