Comparative outcomes and characteristics of biliary, alcoholic and drug-induced pancreatitis based on the National Inpatient Sample (2016-2021)

Omar Alkasabrah; Sameeha Ibrahim; Abdullah Hafeez; Tungki Pratama Umar; Marina Takawy; Tanuj Sharma

Authors Omar Alkasabrah, Sameeha Ibrahim, Abdullah Hafeez, Tungki Pratama Umar, Marina Takawy, Tanuj Sharma.

Abstract

Background Pancreatitis outcomes vary significantly depending on etiology. We compared biliary, alcoholic and drug-induced pancreatitis, focusing on mortality, complications and healthcare resource utilization to inform etiology-specific management strategies.

Methods A nationwide retrospective analysis was conducted using the National Inpatient Sample (NIS) database from 2016-2021. Patients with biliary, alcoholic and drug-induced pancreatitis were identified using International Classification of Diseases, 10th Revision (ICD-10) codes. Logistic regression models were used to compare mortality, complications and healthcare utilization, with biliary pancreatitis as the reference. Adjusted odds ratios (aORs) and regression coefficients were calculated.

Results A total of 287,050 biliary, 451,730 alcoholic, and 27,465 drug-induced pancreatitis hospitalizations were identified. Patients with alcoholic pancreatitis were younger and predominantly male, while those with drug-induced pancreatitis had higher comorbidity burdens, including diabetes, dyslipidemia and hypertension. Mortality was higher in alcoholic pancreatitis (aOR 1.19, 95% confidence interval [CI] 1.06-1.41; P=0.05), whereas drug-induced pancreatitis showed no significant difference. Alcoholic pancreatitis was associated with greater odds of pseudocyst formation (aOR 3.54, 95%CI 3.32-3.79), bleeding (aOR 1.52, 95%CI 1.41-1.63), and mechanical ventilation (aOR 2.06, 95%CI 1.84-2.31), all with P<0.001. In contrast, drug-induced pancreatitis was linked to lower odds of bleeding (aOR 0.69, 95%CI 0.57-0.84; P<0.001) and percutaneous drainage (aOR 0.23, 95%CI 0.09-0.63; P=0.004). Both alcoholic and drug-induced pancreatitis had shorter hospital stays and lower total charges compared with biliary pancreatitis.

Conclusions Alcoholic pancreatitis is associated with higher mortality and complication rates, while drug-induced pancreatitis demonstrates fewer complications but greater comorbidity. These findings highlight the importance of etiology-based management in optimizing pancreatitis outcomes.

Keywords Pancreatitis, biliary, alcoholic, drug-induced, outcomes

Ann Gastroenterol 2026; 39 (4): 438-445