Outcomes of Acute Pancreatitis in Lean Versus Non-lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Patients: A Nationwide Analysis

Document Type

Article

Publication Title

Digestive diseases and sciences

Abstract

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a key contributor to the severity and outcomes of acute pancreatitis (AP). This study compares the clinical outcomes of AP in patients with lean versus non-lean MASLD. METHODS: We identified adult patients hospitalized with AP and a secondary diagnosis of MASLD from the National Inpatient Sample (NIS 2016-2020). Outcomes, including mortality, organ failures, and healthcare utilization, were analyzed using logistic and linear regression models, adjusting for demographic, clinical, and hospital factors. RESULTS: We included 34,388 hospitalized patients with AP and MASLD, of whom 14,443 (42.0%) were non-lean. Annual admissions increased sharply in lean MASLD patients (5339 in 2016 to 8247 in 2020) compared to non-lean MASLD (2273 to 3635). Non-lean MASLD patients experienced higher inflation-adjusted hospital charges ($5,324.01; 95% CI $3,273.42-$7,374.61, P < 0.01), a longer length of stay ((adjusted increase 0.25 days; 95% CI 0.12-0.39, P < 0.05), increased odds of respiratory failure (aOR 4.60; 95% CI 2.24-9.46, P < 0.01), sepsis (aOR 1.11; 95% CI 1.00-1.23, P = 0.04), cholecystectomy (aOR 2.05; 95% CI 1.92-2.19, P < 0.01), and ERCP (aOR of 1.42 95% CI 1.11-1.82, P = 0.01). Mortality did not differ significantly. (aOR 0.90; 95% CI 0.69-1.17, P = 0.43). CONCLUSION: Our study suggests that lean MASLD patients with AP may experience a higher rate of hospital admissions and distinct clinical profiles, including a similar mortality risk compared to non-lean MASLD patients, indicating a complex relationship between AP outcomes and MASLD beyond BMI.

DOI

10.1007/s10620-025-09245-y

Publication Date

7-26-2025

Identifier

40715691 (pubmed); 10.1007/s10620-025-09245-y (doi); 10.1007/s10620-025-09245-y (pii)

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