Investigation of the Association of Acute Pancreatitis Outcomes with Social Vulnerability Indicators

Background and aim: Geospatial analyses integrate location-based sociodemographic data, offering a promising approach to investigate the impact of social determinants on acute pancreatitis outcomes. This study aimed to examine the association of social vulnerability index (SVI) and its constituent 16 attributes in 4 domains (socioeconomic status, household composition and disability, minority status and language, and housing type and transportation), with outcomes in patients with acute pancreatitis.

Methods: This study included acute pancreatitis patients hospitalized between 1/1/2008 and 12/31/2021 and recorded their demographics and clinical outcomes. Physical addresses were geocoded to determine SVI, a composite variable which was ranked and divided into quartiles (I to IV: IV representing the highest vulnerability).

Result: In 824 eligible patients [age of 53.0±10 years and 48.2% females], with 993 acute pancreatitis-related hospitalizations, we noted a significant association in patients residing in communities with higher SVI, a higher prevalence of no/federal/state insurance (P<0.001) and underserved ethinic/racial background (P<0.001). We observed a significant association of alcohol withdrawal in patients with residence in areas with higher SVI despite adjustment for age, body mass index, and comorbidities (OR:1.62[95%CI:1.19-2.22]; p= 0.003). However, we observed no association of SVI with severity of acute pancreatitis, inpatient opioid use, length of stay, 30-day admission rate, and mortality.

Conclusion: We noted significantly higher alcohol withdrawal in patients residing in areas with higher SVI ranks, despite no differences in severity of acute pancreatitis, inpatient opioid use, length of stay, 30-day admission rate, and mortality.