Retrospective Cohort Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Nov 24, 2022; 13(11): 907-917
Published online Nov 24, 2022. doi: 10.5306/wjco.v13.i11.907
Epidemiologic risk factors for patients admitted with chronic pancreatitis and pancreatic ductal adenocarcinoma in the United States
Daniel Lew, Fatima Kamal, Khiem Phan, Karamvir Randhawa, Sam Cornwell, Ayrton I Bangolo, Simcha Weissman, Stephen J Pandol
Daniel Lew, Stephen J Pandol, Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
Fatima Kamal, Khiem Phan, Karamvir Randhawa, Sam Cornwell, Ayrton I Bangolo, Simcha Weissman, Department of Internal Medicine, Hackensack Meridian Health/Palisades Medical Center, North Bergen, NJ 07047, United States
Author contributions: Lew D, Kamal F, Phan K, Randhawa K, Cornwell S, and Weissman S assisted with data acquisition, analyses, and manuscript preparation; Lew D drafted and critically revised the manuscript; Lew D, Weissman S, Bangolo AI, and Pandol SJ provided input regarding methodology; Pandol SJ critically revised the manuscript and provided direct supervision and guidance; Weissman S is the article guarantor; All authors agree to the final version of this manuscript.
Institutional review board statement: This retrospective cohort study utilized the 2016 and 2017 National Inpatient Sample (NIS) databases. The NIS is a database of inpatient stays derived from billing data based upon discharge abstracts. As such, it contains de-identified clinical and nonclinical elements at both the patient and hospital level. Making the need for an Institutional review board approval dispensable.
Informed consent statement: The National Inpatient Database was a public-use dataset, of which the informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: This retrospective cohort study utilized the 2016 and 2017 National Inpatient Sample (NIS) databases. The NIS is a database of inpatient stays derived from billing data based upon discharge abstracts. As such, it contains de-identified clinical and nonclinical elements at both the patient and hospital level. The dataset is publicly available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ayrton I Bangolo, MBBS, MD, Doctor, Department of Internal Medicine, Hackensack Meridian Health/Palisades Medical Center, 7600 River Road, North Bergen, NJ 07047, United States. ayrtonbangolo@yahoo.com
Received: July 28, 2022
Peer-review started: July 28, 2022
First decision: September 5, 2022
Revised: September 8, 2022
Accepted: November 6, 2022
Article in press: November 6, 2022
Published online: November 24, 2022
Processing time: 115 Days and 7.9 Hours
Abstract
BACKGROUND

Epidemiological studies of chronic pancreatitis (CP) and its association with pancreatic ductal adenocarcinoma (PDAC) are limited. Understanding demographic and ethno-racial factors may help identify patients at the highest risk for CP and PDAC.

AIM

To evaluate the ethno-racial risk factors for CP and its association with PDAC. The secondary aim was to evaluate hospitalization outcomes in patients admitted with CP and PDAC.

METHODS

This retrospective cohort study used the 2016 and 2017 National Inpatient Sample databases. Patients included in the study had ICD-10 codes for CP and PDAC. The ethnic, socioeconomic, and racial backgrounds of patients with CP and PDAC were analyzed.

RESULTS

Hospital admissions for CP was 29 per 100000, and 2890 (0.78%) had PDAC. Blacks [adjusted odds ratio (aOR) 1.13], men (aOR 1.35), age 40 to 59 (aOR 2.60), and being overweight (aOR 1.34) were significantly associated with CP (all with P < 0.01). In patients with CP, Whites (aOR 1.23), higher income, older age (aOR 1.05), and being overweight (aOR 2.40) were all significantly associated with PDAC (all with P < 0.01). Men (aOR 1.81) and Asians (aOR 15.19) had significantly increased mortality (P < 0.05). Hispanics had significantly increased hospital length of stay (aOR 5.24) (P < 0.05).

CONCLUSION

Based on this large, nationwide analysis, black men between 40-59 years old and overweight are at significantly increased risk for admission with CP. White men older than 40 years old and overweight with higher income were found to have significant associations with CP and PDAC. This discrepancy may reflect underlying differences in healthcare access and utilization among different socioeconomic and ethno-racial groups.

Keywords: Chronic pancreatitis; Pancreatic cancer; Ethno-racial; Risk factors; Hospitalization outcomes; Adult

Core Tip: What is known chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDAC) rates are rising. Pancreatitis admissions costed 133 million dollars, and accounted for the 3rd leading cause of hospital admissions. There is lack of data identifying those at highest risk for admissions with CP and PDAC. What we found Black men between 40-59 years old and overweight are at significantly increased risk for admission with CP. White men with higher income were found to have significantly increased risk for admissions with CP and PDAC. Asians/Pacific Islanders had the highest risk for mortality from CP and PDAC.