Acute Pancreatitis Mortality Trends in the United States, 1999-2020: An Analysis of the CDC WONDER Database

Background: Acute pancreatitis (AP), a leading cause of U.S. gastrointestinal hospitalizations, involves pancreatic autodigestion. Prior studies, limited to inpatient data, overlooked disparities; this study analyzes nationwide AP-related mortality trends from 1999–2020 across demographic and regional subgroups. Methods: Mortality data were extracted from CDC-WONDER (ICD-10 code K85). Age-adjusted mortality rates (AAMR) and crude mortality rates (CMR) per 1,000,000 people were calculated. Trends were analyzed using Joinpoint regression to compute annual percent change (APC) and average APC (AAPC), stratified by gender, age, race, ethnicity, census region, state, and urbanization. Results: Among 128,051 deaths, AAMR declined from 21.85 in 1999 to 14.65 in 2018, but rose sharply to 18.04 in 2020, with an AAPC of -1.23 (95% CI, -2.21 to -0.25, p = 0.014). Males had a persistently higher AAMR (21.86) than females (13.77). Black individuals exhibited the highest AAMR (35.01 in 1999; 20.90 in 2020), surpassing White populations (20.32 to 18.23). The South had the highest regional mortality rate, while the Northeast had the lowest. Mortality declined in individuals aged 85 + with an APC of -3.61 (95% CI, -3.99 to -3.23, p < 0.001), but younger age groups (15–74 years) exhibited stable CMR from 1999 to 2018, followed by sharp increases during 2018–2020. Conclusion: AP-related mortality declined initially but surged from 2018–2020, particularly among younger populations. Persistent higher mortality rates in males, Black individuals, the younger population, and the Southern region underscore the need for targeted interventions addressing risk factors and healthcare access. Investigating drivers of recent mortality spikes is critical.