S246 Trends in Acute Pancreatitis Hospitalization and In-Hospital Mortality in the United States (1999 to 2023): Evaluating the Role of Healthcare Access and Regional Disparities

Introduction: Acute pancreatitis (AP) is a significant contributor to gastrointestinal mortality and has emerged as a leading cause of gastrointestinal-related hospitalizations in the United States. Despite advances in care, disparities in mortality persist across demographic and geographic groups. This study aims to assess factors influencing hospitalization rates and examine disparities in healthcare access, regional variation, and demographics from 1999 to 2023. Methods: A retrospective analysis of AP-related mortality in adults aged ≥25 years was conducted using the CDC WONDER database (1999 to 2023), using the ICD-10 code K85. Age-adjusted mortality rates (AAMRs) per 100,000 were standardized to the 2000 U.S. population. Joinpoint regression assessed annual percent changes and average annual percent change (AAPC) by race, ethnicity, region, and urbanization status. Results: From 1999 to 2023, 146,835 AP-related deaths were recorded, with most occurring in medical facilities (111,905). National AAMR declined from 3.31 to 2.49, with a significant AAPC of -1.1% (95% CI: -2.12 to -0.07, P = 0.036). Men had higher mortality than women (82,454 vs 64,381), with 2023 AAMRs of 3.14 vs 1.88 and AAPCs of -1.05% vs -1.3%. Racially, NH White individuals had the highest mortality (110,870 deaths), with AAMR dropping from 3.07 to 2.72 (AAPC: -0.59, P = 0.409). Geographically, the South had the most deaths (59,340, AAPC: -1.43, P = 0.062), while the Northeast had the least (23,304, AAPC: -1.6, P = 0.073). Non-metropolitan areas had higher AAMRs than metropolitan areas (3.26 vs 2.57), but metropolitan areas recorded more deaths (100,560, AAPC: -1.42, P = 0.003). Southern and Midwestern states, especially South Carolina (3.95), Kentucky (3.94), and Mississippi (3.74), had the highest AAMRs. In contrast, states like New York (2.00), Massachusetts (2.24), and Pennsylvania (2.40) had lower-than-average mortality. Conclusion: Although mortality due to AP has slightly declined over the past 25 years, significant demographic, regional, and healthcare access disparities persist, underscoring the need for equity-focused interventions in high-risk and geographically vulnerable areas.