Epidemiology of acute pancreatitis: the influence of age and gender in a regional population

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Abstract
Acute pancreatitis (AP) is a common and potentially severe inflammatory condition of the pancreas with a heterogeneous etiology influenced by geographic, demographic, and lifestyle factors. This study aimed to evaluate the distribution of AP etiologies and their associations with age and sex in a regional cohort from a tertiary center. This retrospective observational study included 445 adult patients hospitalized with a first episode of AP between January 2022 and October 2023. Data on demographics, etiology, severity (revised Atlanta classification), hospital course, and outcomes were extracted from medical records. Etiologies were classified as biliary, idiopathic, alcohol-related, drug-induced, hypertriglyceridemia (HTG), neoplasm-associated, or other miscellaneous causes. Age was grouped into five categories, and statistical analyses assessed the association between etiologies and demographic variables. The median age was 65 years (range: 18–97), and 52.1% were female. Biliary etiology was the most frequent (66.1%), followed by idiopathic (9.4%), alcohol-related (7.0%), drug-induced (6.5%), neoplasm-associated (4.3%), and HTG-induced (3.1%). Females were significantly older than males (median 67 vs. 60 years, p < 0.001). Alcohol-related AP (AAP) was more common in males, particularly under age 55. Notably, among biliary AP (BAP) patients, males predominated in those under 55 (p = 0.02). Etiological patterns varied significantly by age. In patients aged ≥ 75 years, BAP was markedly more common (80.4% vs. 61.8%), whereas alcohol, drug, and HTG-related etiologies were rare. Severity of AP correlated with age and length of stay but not with etiology. Biliary pancreatitis remains the predominant etiology in this region, especially among elderly patients. A novel finding of male predominance in younger BAP cases warrants further investigation. These data underscore the importance of regional age and sex specific approaches to AP prevention and management.

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