Gender-Related Differences in Hospitalization Outcomes of Acute Pancreatitis: A Retrospective Analysis

Cureus. 2025 Jun 19;17(6):e86371. doi: 10.7759/cureus.86371. eCollection 2025 Jun.

Abstract

Background Acute pancreatitis (AP) is a common gastrointestinal condition that frequently necessitates hospitalization. The aim of our study is to investigate whether gender affects the outcomes of adult patients hospitalized with AP. Methods Using the Nationwide Inpatient Sample (NIS) database 2020 and the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes, we performed a retrospective study of adult patients admitted with AP. We compared inpatient outcomes of AP between males and females. The primary outcome was all-cause inpatient mortality. Secondary outcomes were length of stay (LOS), total healthcare cost utilization, incidence of acute renal failure (ARF), sepsis, shock, and the need for intensive care unit (ICU) admission. We used STATA Version 16.1 to perform the statistical analyses. Multivariate logistic regression analysis was conducted to assess if gender was an independent predictor for these outcomes and to adjust for any confounders. Results A total of 252,595 adult patients were admitted for AP in 2020. The mean age was 50.89 years, and 139,180 (55.1 %) of the patients were males. Female patients had a higher prevalence of chronic kidney disease (9.26% vs 8.47%, P < 0.01), congestive heart failure (6.48% vs 5.69%, P < 0.01), and obesity (23.37% vs 17.39%, P < 0.01). Male patients had a higher prevalence of diabetes mellitus type 2 (27.32% vs 24.68%, P < 0.01), diabetes mellitus type 1 (1.32% vs 1.25%, P = 0.5), liver cirrhosis (1.81% vs 1.75%, P = 0.61), and smoking/tobacco use (39.38% vs 29.28%, P < 0.01). Females had significantly lower likelihood of in-hospital mortality (aOR: 0.64, 95% CI: 0.51-0.82, P < 0.01), ARF (aOR 0.72, 95% CI: 0.68-0.76, P < 0.01), sepsis (aOR: 0.68, 95% CI: 0.63-0.75, P < 0.01), and shock (aOR: 0.74, 95% CI: 0.62-0.89, P < 0.01) than males. There was no statistically significant difference between LOS, total hospitalization charges, and ICU admission between the two genders. Conclusions We found that females had significantly improved clinical outcomes, including lower mortality, ARF, sepsis, and shock, as compared to males. There was no statistical difference between the two genders in LOS, total hospitalization charges, and ICU admission. Further prospective studies are needed to accurately understand these differences to guide clinical practice.

Keywords: acute pancreatitis; alcoholic pancreatitis; biliary pancreatitis; male versus female; nationwide inpatient sample.