Burden of Nonmalignant Liver and Pancreatic Diseases in the United States Population: Rates and Trends

Abstract

Nonmalignant liver and pancreatic diseases are common in the United States and lead to significant morbidity, mortality, and health care utilization. We used national survey and claims databases to investigate rates and trends in the liver and pancreatic disease burden over the past decade in the United States. The Nationwide Emergency Department Sample, National Inpatient Sample, Vital Statistics of the United States: Multiple Cause-of-Death Data, Optum Clinformatics Data Mart, and Centers for Medicare and Medicaid Services Medicare 5% Sample and Medicaid files were used to estimate claims-based prevalence, medical care use, and mortality with an all-listed liver or pancreatic disease diagnosis. In the US population, liver disease contributed to 2.7 million emergency department visits, 2 million hospital stays, and 134,000 deaths in 2021. Pancreatitis was a less common but still significant cause of health care use contributing to 733,000 emergency department visits, 552,000 hospital stays, and 9000 deaths in 2021. For both conditions, male and American Indian/Alaska Native persons had a greater mortality and medical care use burden. During the study period, both medical care use and mortality rates with a liver disease diagnosis rose, concerningly reversing previously declining trends. For pancreatitis, medical care use rates stabilized or declined during recent years and the mortality rate declined through 2019 and then rose through 2021. The burden of nonmalignant liver and pancreatic diseases in the United States is substantial. The rise in liver disease mortality rates following the reversal of a previous downward trend is particularly concerning. Hence ongoing surveillance of liver disease and pancreatitis prevalence may better inform research programs.