Longitudinal Study of Comorbidities and Clinical Outcomes in Persons With Pancreatic Disease Using Electronic Health...

We examined comorbidities and clinical outcomes among persons with pancreatic disease using electronic health records (EHR).

In this retrospective study of 1,039,035 adults, pancreatic disease was defined by ICD-9 or ICD-10 codes using Optum longitudinal EHR from January 2007 through December 2023. We obtained demographics, diagnosis, prescription, and vital sign records and evaluated associations with chronic pancreatitis, pancreatic cancer, and mortality.

Among patients with pancreatic disease, 17.6% had a chronic pancreatitis diagnosis during study follow-up, and chronic pancreatitis was associated with male sex, Black race, lower BMI, acute pancreatitis, other pancreatic disease, diabetes, hypertension, chronic liver disease, gastroesophageal reflux disease, depression or anxiety, abdominal pain, and alcohol dependence. A pancreatic cancer diagnosis was identified during follow-up among 12.1% of patients with pancreatic disease, and pancreatic cancer was associated with older age, male sex, lower BMI, chronic pancreatitis, other pancreatic disease, diabetes, cancers except primary liver and colorectal, and abdominal pain. Blacks and Asians were less likely to have pancreatic cancer compared with Whites. Mortality among patients with pancreatic disease was 28.8% compared with 9.7% for the whole EHR sample. Mortality was associated with older age, male sex, Black race, lower BMI, pancreatic cancer, diabetes, hypertension, ischemic heart disease, other cancers, chronic liver disease, depression or anxiety, and alcohol dependence.

In this EHR analysis of patients with pancreatic disease, chronic pancreatitis, and pancreatic cancer diagnoses were frequent, and mortality was higher compared with the whole EHR sample. Metabolic dysfunction-associated clinical outcomes were common among persons with pancreatic disease.