Shifting Patterns in Pancreatic Cancer- Trends in Hospitalizations in U.S.A

Shifting Patterns in Pancreatic Cancer- Trends in Hospitalizations in U.S.A | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Shifting Patterns in Pancreatic Cancer- Trends in Hospitalizations in U.S.A Silpa Choday, Eric Tran, Anthony Yeung, Neil Vyas This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6131810/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Pancreatic cancer remains one of the deadliest cancers with rising mortality and incidence rates worldwide. This study analyzes recent trends in pancreatic cancer to understand the demographic and temporal shifts in its outcomes. Methods: A retrospective cohort study was conducted using Nationwide Inpatient Sample (NIS) database from 2016 until 2020, to identify pancreatic cancer hospitalization, discharges, and investigate outcomes. Trends were adjusted for age, sex, race, insurance type, mean household income, and hospital characteristics. Multivariable logistic regression has been used to analyze the data. Results: A total of 103,588,729 records were analyzed, identifying 111,250 cases with a diagnosis of pancreatic cancer. From 2016 to 2020, hospitalizations remained relatively stable, with a slight decrease from 37,434 to 36,510. The mean age at diagnosis was 68 years (P<0.001). Males were slightly more affected than females. The highest prevalence was observed in the White population (70%), followed by African Americans (13.9%) and Hispanics (8.3%) (P<0.001). Notably, the prevalence among Hispanics increased from 8.3% to 9.1%, (P<0.001). Inpatient mortality decreased from 6.9% to 4.9% (P<0.001), and the mean hospital stay reduced from 7.1 to 6.8 days. However, hospital charges increased from $88,778 to $100,278. Conclusion: Risk factors include male sex, with the mean age at diagnosis being 68 years. The incidence among the Hispanic population has been increasing over the years. Although inpatient mortality has decreased, this may be due to terminally ill patients opting for end-of-life care at home or in hospice, which is not recorded in the database. Pancreatic cancer Trends Cancer Mortality Comorbidities Hospitalizations Figures Figure 1 Figure 2 Introduction Pancreatic cancer is a malignancy with poor prognosis and high mortality. The incidence is increasing by 0.5–1.0% per year, and it is projected to become the second-leading cause of cancer-related mortality by 2030 [ 1 ]. The global burden of pancreatic cancer has increased dramatically over the past few decades and is expected to continue to represent a leading cause of cancer-related mortality [ 2 ]. According to recent statistics, it is estimated to be the 12th most common cancer worldwide, with around 495,773 new cases diagnosed in 2020 alone [ 3 ]. Understanding the risk factors associated with pancreatic cancer is crucial for prevention and early detection as it is characterized by its aggressive nature, poor prognosis, and limited treatment options [ 4 ]. Early detection of pancreatic cancer remains a significant challenge due to its non-specific symptoms in the early stages and lack of effective screening tests. Most cases are diagnosed at advanced stages when treatment options are limited, and prognosis is poor [ 5 ]. Despite advances in treatment modalities, the overall survival rates for pancreatic cancer remain low, emphasizing the need for continued research into novel therapeutic approaches [ 6 ]. Methods The study analyzed hospitalizations principally for pancreatic cancer in the US. The complete dataset was obtained from the NIS spanning 2016 to 2020. This extensive, comprehensive database encompasses national hospital discharges. It is meticulously maintained as an integral component of the healthcare cost and utilization project (HCUP) by the agency for healthcare research and quality (AHRQ). This sample includes community, general hospitals, and academic medical centers but excludes long-term facilities. Hospitals were divided based on geographic region, urban vs. rural location, teaching status, ownership, and number of beds. Each record in the NIS represents a single hospital discharge and includes a unique identifier, demographic data (age, gender, and race), hospital transfer status, admission type (emergent, urgent, or elective), primary and secondary diagnoses (up to 15), primary and secondary procedures (up to 15), expected primary and secondary insurance payers, total hospital charges, LOS and hospital characteristics (region, urban vs. rural location, bed-size and teaching status). A multivariate regression analysis with STATA was used to calculate the trend in mortality, length of stay (LOS), and total hospital costs (THC) following adjustment for age, sex, race, grouped with Charlson comorbidity index, insurance type, mean household income, and hospital characteristics. The calculation of total hospital costs involved utilizing HCUP Cost-to-Charge Ratio files. Institutional review board approval was not needed for this database study. Results A total of 103,588,729 records were analyzed, identifying 111,250 cases with a diagnosis of pancreatic cancer. From 2016 to 2020, hospitalizations remained relatively stable, with a slight decrease from 37,434 to 36,510. The number of hospitalizations showed a significant decrease over time: 37,435 in 2016, 37,305 in 2018, and 36,510 in 2020 (P < 0.001). The mean age increased slightly from 68.03 years in 2016 to 68.5 years in 2020 (P < 0.001) [Table 1 ]. The proportion of males decreased from 51.51% in 2016 to 51.1% in 2020. There were significant differences in racial demographics over the years (P < 0.001), with consistent proportions of White (70–71%), Black (13–14%), Hispanic (8–9%), and other races (6–8%). Notably, the prevalence among Hispanics increased from 8.3–9.1%, while it remained stable in other demographics (P < 0.001). There is a significant change observed in health insurance coverage (P < 0.001), with Medicare increasing from 57.9% in 2016 to 60.3% in 2020, while private insurance decreased from 27.7–25.5%. There are several comorbidities that showed significant changes, There is an increased prevalence of smoking (27.0–31.0%, P < 0.001), heart failure (6.3–8.6%, P < 0.001), HTN (9.0–16.0%, P < 0.001), obesity (10.3–12.7%, P < 0.001), COPD (14.4–16.5%, P < 0.001), renal failure (6.7–8.6%, P < 0.001), and diabetes complications (14.5–21%, P < 0.001), coagulopathy (10.4–11%, P < 0.020), Lymphoma (0.2–0.8%, P < 0.001). There was a decrease in the prevalence of cancer (49.2–46.0%, P = 0.020), PVD (5.6–4.8%, P < 0.002), no significant change in the prevalence of PUD, (2.9–3.8%, P = 0.007). There was no significant change in the prevalence of alcohol use, with rates of 3.6% in 2016, 3.7% in 2018, and 3.4% in 2020 (P = 0.600) [Table 1 ]. Inpatient mortality rates declined from 6.9% in 2016 to 4.9% in 2020 (P < 0.001). The mean length of hospital stay showed a slight decrease from 7.1 days to 6.8 days (P < 0.001) [Table 2 ]. Mean total hospital charges increased significantly from $ 88,778 in 2016 to $ 100,278 in 2020 (P < 0.001, adjusted for inflation to 2020 USD) [Figure 1 ]. The percentage of patients discharged to home increased from 51% in 2016 and 2018 to 53% in 2020 (P < 0.001), Dc to home with HH from 24.8–30% (P < 0.001). DC decreased to skilled nursing facility (SNF) 14.4–10.2% (P < 0.001) and short-term facility (STF) 2.5–1.8% (P < 0.001) [Figure 2 ]. Table 1 Baseline characteristics Year 2016 2018 2020 P value* Hospitalizations (n) 37,435 37,305 36,510 < 0.001 Age, years - mean (SE) 68.03 68.13 68.5 < 0.001** Males 51.51 49.44 51.1 Females (%) 48.0 50.0 48.0 0.03 Race (%) < 0.001 White 70.9 69.6 70.4 Black 13.9 13.5 13.4 Hispanic 8.3 9.0 9.1 Other 6.8 7.6 7.1 Health insurance (%) < 0.001 Medicare 57.9 59.8 60.3 Medicaid 8.8 9.1 9.0 Private 27.7 26.0 25.5 Self-pay 2.2 2.1 2.1 Other Comorbidities Smoking 27.0 29.0 31.0 < 0.001 Alcohol 3.6 3.7 3.4 0.600 Heart Failure 6.3 7.3 8.6 < 0.001 HTN 9.0 14.0 16.0 < 0.001 Obesity 10.3 11.3 12.7 < 0.001 COPD 14.4 15.0 16.5 < 0.001 Renal Failure 6.7 8.2 8.6 < 0.001 Cancer 49.2 48.6 46.0 0.020 Pulm cir dis 1.3 1.5 1.9 0.020 PUD 2.9 3.8 3.8 0.007 Coagulopathy 10.4 10.3 11.0 0.020 Lymphoma 0.2 0.6 0.8 < 0.001 PVD 5.6 4.8 6.2 0.002 Diabetes cx 14.5 19.6 21.0 < 0.001 Hospital Location / Teaching Status (%) < 0.001 Rural 4.1 3.5 3.3 Urban - non-teaching 17.6 13.4 11.3 Urban - teaching 78.2 83.0 85.0 Table 2 Outcomes of Hospitalizations Year 2016 2018 2020 P value Hospitalizations (n) 37,435 37,305 36,510 < 0.001 Inpatient mortality (%) 6.9 6.3 4.9 < 0.001 Mean length of stay (days) 7.1 7.0 6.8 < 0.001 Mean total hospital charges ( $ US, 2020**) 88,778 95,160 100,278 < 0.001 Discharged to Home 51 51 53 < 0.001 Discharged to short term care 2.5 2.2 1.8 < 0.001 Discharge to Home with HH 24.8 26.4 30 < 0.001 Discharged to SNF 14.4 14 10.2 < 0.001 Left Against Medical Advice 0.3 0.3 0.4 < 0.001 Discussion This discussion focuses on the analysis of hospitalization data spanning from 2016 to 2020, with epidemiological trends, patient demographics, healthcare utilization, clinical outcomes, and healthcare disparities. Pancreatic cancer remains a formidable challenge in oncology due to its aggressive nature, late diagnosis, and limited treatment options. The incidence of pancreatic cancer varies globally, with higher rates observed in developed regions such as North America and Europe [ 7 ]. Several established risk factors contribute to the development of pancreatic cancer, including age, smoking, obesity, and a family history of the disease [ 8 ]. The study analyzed a vast dataset comprising over 103 million records, identifying 111,250 cases of pancreatic cancer. Hospitalization rates for pancreatic cancer remained relatively stable over the study period, with a slight decrease from 37,434 in 2016 to 36,510 in 2020. Interestingly, while the overall rate decreased, the mean age of hospitalized patients increased marginally from 68.03 years to 68.5 years (P < 0.001). This slight aging trend could indicate improved longevity among affected individuals or shifting diagnosis patterns. The proportion of males among cases decreased from 51.51% in 2016 to 51.1% in 2020, suggesting a modest narrowing of the gender disparity. Racial demographics showed notable changes, particularly an increase in the prevalence among Hispanic individuals from 8.3–9.1%, while other racial groups remained stable. Pancreatic cancer is a highly dangerous malignancy, contributing to an estimated 3% of new cancer diagnoses in 2024, and yet will contribute to 8% of cancer related deaths [ 9 ]. Despite this, the 5-year relative survival rates among all races and ethnicities diagnosed with pancreatic cancer was 13% from 2013 until 2019 compared to 25% for lung, 97% for prostate and 64% for colon cancers respectively [ 9 ]. Racial disparities in pancreatic cancer prevalence were evident, with the highest incidence observed among White individuals (70%), followed by African Americans (13.9%) and Hispanics (8.3%) [Table 1 ]. The study highlighted a notable increase in prevalence among Hispanics, rising from 8.35 to 9.1% over five years. These findings highlight the importance of addressing genetic predisposition, race, access to healthcare, cultural factors that contribute to health disparities among varied racial and ethnic groups. Medicare emerged as the predominant insurance provider with a decrease in usage of private insurance and Medicaid. These trends reflect socioeconomic factors that influence adequate coverage for cancer care. A significant decrease in inpatient mortality rates from 6.9–4.9% (P < 0.001) suggests improvements in hospital care and early intervention strategies. The mean length of hospital stays also declined slightly, from 7.1 days to 6.8 days (P < 0.001), indicating potential advances in treatment efficiency.The prevalence of several comorbidities associated with pancreatic cancer, including smoking, heart failure, obesity, hypertension, COPD, renal failure, coagulopathy, lymphomas, PUD, PVD and diabetes, showed increasing trends over the study period. These findings highlight the complex clinical profiles and multi-morbid conditions. Discharge patterns indicated stability in discharges to home, while there was a notable increase in discharges to home with HH. This shift suggests evolving healthcare delivery models aimed at optimizing post-hospitalization recovery and supportive care for patients with complex healthcare needs. A 2012 study comparing the trends of pancreatic resection for malignancy in 1993–2005 showed a decrease in patients discharged to home (74.5–53.7%) and an increase in discharges to home with HH (20.0–33.0%) [ 10 ]. This is due to pancreatic cancer presenting later in life, over 70, and patients opting for comfort at home with assistance from health care providers. However, the study noted a concerning increase in mean hospital charges, rising from $ 88,778 to $ 100,278. These patients often require longer post-discharge assistance planning, increasing healthcare costs [ 10 ]. In general, annual costs for cancer diagnosis, medical services, and treatment were highest in the end-of-life phase with $ 109,727 for medical services and $ 4,372 for oral prescription drugs [ 11 ]. The costs were significantly higher for treating advanced and metastatic cancer ( $ 21,637) compared to non-metastatic disease ( $ 10,358) (P < .001) [ 12 ][ 13 ]. This shows the economic burden associated with managing pancreatic cancer, necessitating continued efforts in cost-effective care delivery and resource allocation. Conclusions Pancreatic cancer is a devastating disease characterized by a poor 5-year survival rate and significant economic burdens for treatment. The key findings from our study reveal stable hospitalization rates, despite an increasing prevalence among certain demographic groups such as Hispanics. There is a higher incidence among males and a White population. The prevalence of several comorbidities associated with pancreatic cancer has shown an upward trend, highlighting ongoing challenges in managing these complex cases. Despite minor improvements in therapy and surgical methods, the inherently high cost of chemotherapy exacerbates the economic burden. It is important to identify the related risk factors and populations that are at a high risk, in addition to achieving early diagnosis based on clinical examinations or biomarkers. Abbreviations AHRQ Agency for healthcare research and quality COPD Chronic obstructive pulmonary disease DC Discharge HH Home health HTN Hypertension HCUP Healthcare cost and utilization project LOS length of stay NIS Nationwide Inpatient Sample PUD Peptic ulcer disease PVD Peripheral vascular disease SNF Skilled nursing facility STF Short term facility THC total hospital costs Declarations Institutional Review Board Approval: Not needed as the data has been collected from public databases. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Financial Disclosures/Funding: Not applicable. Informed Consent: Not applicable Author Contribution SC, as the first author collected articles, generated tables, wrote most of the sections, and was a major contributor to writing the manuscript. ET and AY as a second and third author gathered relevant articles and contributed to the discussion section of the manuscript. NV as a senior author reviewed the article and made necessary changes to the manuscript. All authors read and approved the final manuscript. References Park W, Chawla A, O'Reilly EM. Pancreatic Cancer: A Review. JAMA. 2021;326(9):851–862. doi: 10.1001/jama.2021.13027. Erratum in: JAMA. 2021;326(20):2081. doi: 10.1001/jama.2021.19984 . [PubMed] [Google Scholar] GBD 2017 Pancreatic Cancer Collaborators. The global, regional, and national burden of pancreatic cancer and its attributable risk factors in 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol. Hepatol. 4, 934–947 (2019). [PMC free article] [PubMed] [Google Scholar] Maisonneuve P, et al. Epidemiology of pancreatic cancer: an overview. Nat Rev Gastroenterol Hepatol. 2016;13(2):73–85. [PubMed] [Google Scholar] [CrossRef] Rahib L, et al. 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Healthcare costs, treatment patterns, and resource utilization among pancreatic cancer patients in a managed care population. J Med Econ. 2013;16(12):1379–1386. [PubMed] [Google Scholar] Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6131810","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":427765750,"identity":"3d881fd1-cf96-4a50-aa07-353eecedb358","order_by":0,"name":"Silpa Choday","email":"data:image/png;base64,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","orcid":"","institution":"Creighton University School of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Silpa","middleName":"","lastName":"Choday","suffix":""},{"id":427765751,"identity":"caec9113-6be1-47d4-8fea-0125e65ebd9d","order_by":1,"name":"Eric Tran","email":"","orcid":"","institution":"Creighton University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Eric","middleName":"","lastName":"Tran","suffix":""},{"id":427765755,"identity":"8af80155-19f4-48ff-8283-8d3be769a310","order_by":2,"name":"Anthony Yeung","email":"","orcid":"","institution":"Creighton University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Anthony","middleName":"","lastName":"Yeung","suffix":""},{"id":427765757,"identity":"e414af27-4e36-4f43-97d4-0ea9ef294b9e","order_by":3,"name":"Neil Vyas","email":"","orcid":"","institution":"Creighton University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Neil","middleName":"","lastName":"Vyas","suffix":""}],"badges":[],"createdAt":"2025-03-01 00:38:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6131810/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6131810/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":78748891,"identity":"d3b199f4-211c-4724-8353-e068c85d962f","added_by":"auto","created_at":"2025-03-18 11:15:49","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":28054,"visible":true,"origin":"","legend":"\u003cp\u003eTrend for Discharges\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6131810/v1/532e1b04f4b41ff40057f2d9.png"},{"id":78749565,"identity":"f4438524-0fd4-45d8-a781-64a5fcc19aa2","added_by":"auto","created_at":"2025-03-18 11:23:49","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":24211,"visible":true,"origin":"","legend":"\u003cp\u003eTrend for Hospitalization and utilizations\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6131810/v1/544ce28474005100b173fab9.png"},{"id":100356068,"identity":"53748dea-e722-416a-8527-8b3289e48bc7","added_by":"auto","created_at":"2026-01-16 06:47:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":568326,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6131810/v1/471b8a14-46c2-49a3-a1a6-59d7ede75365.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Shifting Patterns in Pancreatic Cancer- Trends in Hospitalizations in U.S.A","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePancreatic cancer is a malignancy with poor prognosis and high mortality. The incidence is increasing by 0.5\u0026ndash;1.0% per year, and it is projected to become the second-leading cause of cancer-related mortality by 2030 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The global burden of pancreatic cancer has increased dramatically over the past few decades and is expected to continue to represent a leading cause of cancer-related mortality [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. According to recent statistics, it is estimated to be the 12th most common cancer worldwide, with around 495,773 new cases diagnosed in 2020 alone [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Understanding the risk factors associated with pancreatic cancer is crucial for prevention and early detection as it is characterized by its aggressive nature, poor prognosis, and limited treatment options [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Early detection of pancreatic cancer remains a significant challenge due to its non-specific symptoms in the early stages and lack of effective screening tests. Most cases are diagnosed at advanced stages when treatment options are limited, and prognosis is poor [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Despite advances in treatment modalities, the overall survival rates for pancreatic cancer remain low, emphasizing the need for continued research into novel therapeutic approaches [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe study analyzed hospitalizations principally for pancreatic cancer in the US. The complete dataset was obtained from the NIS spanning 2016 to 2020. This extensive, comprehensive database encompasses national hospital discharges. It is meticulously maintained as an integral component of the healthcare cost and utilization project (HCUP) by the agency for healthcare research and quality (AHRQ). This sample includes community, general hospitals, and academic medical centers but excludes long-term facilities. Hospitals were divided based on geographic region, urban vs. rural location, teaching status, ownership, and number of beds. Each record in the NIS represents a single hospital discharge and includes a unique identifier, demographic data (age, gender, and race), hospital transfer status, admission type (emergent, urgent, or elective), primary and secondary diagnoses (up to 15), primary and secondary procedures (up to 15), expected primary and secondary insurance payers, total hospital charges, LOS and hospital characteristics (region, urban vs. rural location, bed-size and teaching status).\u003c/p\u003e \u003cp\u003eA multivariate regression analysis with STATA was used to calculate the trend in mortality, length of stay (LOS), and total hospital costs (THC) following adjustment for age, sex, race, grouped with Charlson comorbidity index, insurance type, mean household income, and hospital characteristics. The calculation of total hospital costs involved utilizing HCUP Cost-to-Charge Ratio files. Institutional review board approval was not needed for this database study.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 103,588,729 records were analyzed, identifying 111,250 cases with a diagnosis of pancreatic cancer. From 2016 to 2020, hospitalizations remained relatively stable, with a slight decrease from 37,434 to 36,510. The number of hospitalizations showed a significant decrease over time: 37,435 in 2016, 37,305 in 2018, and 36,510 in 2020 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The mean age increased slightly from 68.03 years in 2016 to 68.5 years in 2020 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) [Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e]. The proportion of males decreased from 51.51% in 2016 to 51.1% in 2020. There were significant differences in racial demographics over the years (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with consistent proportions of White (70\u0026ndash;71%), Black (13\u0026ndash;14%), Hispanic (8\u0026ndash;9%), and other races (6\u0026ndash;8%). Notably, the prevalence among Hispanics increased from 8.3\u0026ndash;9.1%, while it remained stable in other demographics (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). There is a significant change observed in health insurance coverage (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with Medicare increasing from 57.9% in 2016 to 60.3% in 2020, while private insurance decreased from 27.7\u0026ndash;25.5%.\u003c/p\u003e \u003cp\u003eThere are several comorbidities that showed significant changes, There is an increased prevalence of smoking (27.0\u0026ndash;31.0%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), heart failure (6.3\u0026ndash;8.6%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), HTN (9.0\u0026ndash;16.0%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), obesity (10.3\u0026ndash;12.7%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), COPD (14.4\u0026ndash;16.5%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), renal failure (6.7\u0026ndash;8.6%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and diabetes complications (14.5\u0026ndash;21%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), coagulopathy (10.4\u0026ndash;11%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.020), Lymphoma (0.2\u0026ndash;0.8%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). There was a decrease in the prevalence of cancer (49.2\u0026ndash;46.0%, P\u0026thinsp;=\u0026thinsp;0.020), PVD (5.6\u0026ndash;4.8%, P\u0026thinsp;\u0026lt;\u0026thinsp;0.002), no significant change in the prevalence of PUD, (2.9\u0026ndash;3.8%, P\u0026thinsp;=\u0026thinsp;0.007). There was no significant change in the prevalence of alcohol use, with rates of 3.6% in 2016, 3.7% in 2018, and 3.4% in 2020 (P\u0026thinsp;=\u0026thinsp;0.600) [Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eInpatient mortality rates declined from 6.9% in 2016 to 4.9% in 2020 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The mean length of hospital stay showed a slight decrease from 7.1 days to 6.8 days (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) [Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e]. Mean total hospital charges increased significantly from \u003cspan\u003e$\u003c/span\u003e88,778 in 2016 to \u003cspan\u003e$\u003c/span\u003e100,278 in 2020 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001, adjusted for inflation to 2020 USD) [Figure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e]. The percentage of patients discharged to home increased from 51% in 2016 and 2018 to 53% in 2020 (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), Dc to home with HH from 24.8\u0026ndash;30% (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). DC decreased to skilled nursing facility (SNF) 14.4\u0026ndash;10.2% (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and short-term facility (STF) 2.5\u0026ndash;1.8% (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) [Figure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYear\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2020\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP value*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospitalizations (n)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37,435\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37,305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36,510\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, years - mean (SE)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRace (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHispanic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealth insurance (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedicare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedicaid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-pay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eComorbidities\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlcohol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.600\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHeart Failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHTN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObesity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCOPD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRenal Failure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCancer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePulm cir dis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePUD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoagulopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.020\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLymphoma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePVD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiabetes cx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHospital Location / Teaching Status (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban - non-teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban - teaching\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e78.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eOutcomes of Hospitalizations\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYear\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2016\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2020\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHospitalizations (n)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37,435\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37,305\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36,510\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInpatient mortality (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean length of stay (days)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean total hospital charges (\u003cspan\u003e$\u003c/span\u003eUS, 2020**)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e88,778\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95,160\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100,278\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDischarged to Home\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDischarged to short term care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDischarge to Home with HH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDischarged to SNF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeft Against Medical Advice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis discussion focuses on the analysis of hospitalization data spanning from 2016 to 2020, with epidemiological trends, patient demographics, healthcare utilization, clinical outcomes, and healthcare disparities. Pancreatic cancer remains a formidable challenge in oncology due to its aggressive nature, late diagnosis, and limited treatment options. The incidence of pancreatic cancer varies globally, with higher rates observed in developed regions such as North America and Europe [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Several established risk factors contribute to the development of pancreatic cancer, including age, smoking, obesity, and a family history of the disease [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study analyzed a vast dataset comprising over 103\u0026nbsp;million records, identifying 111,250 cases of pancreatic cancer. Hospitalization rates for pancreatic cancer remained relatively stable over the study period, with a slight decrease from 37,434 in 2016 to 36,510 in 2020. Interestingly, while the overall rate decreased, the mean age of hospitalized patients increased marginally from 68.03 years to 68.5 years (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). This slight aging trend could indicate improved longevity among affected individuals or shifting diagnosis patterns.\u003c/p\u003e \u003cp\u003eThe proportion of males among cases decreased from 51.51% in 2016 to 51.1% in 2020, suggesting a modest narrowing of the gender disparity. Racial demographics showed notable changes, particularly an increase in the prevalence among Hispanic individuals from 8.3\u0026ndash;9.1%, while other racial groups remained stable.\u003c/p\u003e \u003cp\u003ePancreatic cancer is a highly dangerous malignancy, contributing to an estimated 3% of new cancer diagnoses in 2024, and yet will contribute to 8% of cancer related deaths [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Despite this, the 5-year relative survival rates among all races and ethnicities diagnosed with pancreatic cancer was 13% from 2013 until 2019 compared to 25% for lung, 97% for prostate and 64% for colon cancers respectively [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Racial disparities in pancreatic cancer prevalence were evident, with the highest incidence observed among White individuals (70%), followed by African Americans (13.9%) and Hispanics (8.3%) [Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e]. The study highlighted a notable increase in prevalence among Hispanics, rising from 8.35 to 9.1% over five years. These findings highlight the importance of addressing genetic predisposition, race, access to healthcare, cultural factors that contribute to health disparities among varied racial and ethnic groups.\u003c/p\u003e \u003cp\u003eMedicare emerged as the predominant insurance provider with a decrease in usage of private insurance and Medicaid. These trends reflect socioeconomic factors that influence adequate coverage for cancer care. A significant decrease in inpatient mortality rates from 6.9\u0026ndash;4.9% (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001) suggests improvements in hospital care and early intervention strategies. The mean length of hospital stays also declined slightly, from 7.1 days to 6.8 days (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating potential advances in treatment efficiency.The prevalence of several comorbidities associated with pancreatic cancer, including smoking, heart failure, obesity, hypertension, COPD, renal failure, coagulopathy, lymphomas, PUD, PVD and diabetes, showed increasing trends over the study period. These findings highlight the complex clinical profiles and multi-morbid conditions.\u003c/p\u003e \u003cp\u003eDischarge patterns indicated stability in discharges to home, while there was a notable increase in discharges to home with HH. This shift suggests evolving healthcare delivery models aimed at optimizing post-hospitalization recovery and supportive care for patients with complex healthcare needs. A 2012 study comparing the trends of pancreatic resection for malignancy in 1993\u0026ndash;2005 showed a decrease in patients discharged to home (74.5\u0026ndash;53.7%) and an increase in discharges to home with HH (20.0\u0026ndash;33.0%) [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This is due to pancreatic cancer presenting later in life, over 70, and patients opting for comfort at home with assistance from health care providers.\u003c/p\u003e \u003cp\u003eHowever, the study noted a concerning increase in mean hospital charges, rising from \u003cspan\u003e$\u003c/span\u003e88,778 to \u003cspan\u003e$\u003c/span\u003e100,278. These patients often require longer post-discharge assistance planning, increasing healthcare costs [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. In general, annual costs for cancer diagnosis, medical services, and treatment were highest in the end-of-life phase with \u003cspan\u003e$\u003c/span\u003e109,727 for medical services and \u003cspan\u003e$\u003c/span\u003e4,372 for oral prescription drugs [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The costs were significantly higher for treating advanced and metastatic cancer (\u003cspan\u003e$\u003c/span\u003e21,637) compared to non-metastatic disease (\u003cspan\u003e$\u003c/span\u003e10,358) (P\u0026thinsp;\u0026lt;\u0026thinsp;.001) [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e][\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. This shows the economic burden associated with managing pancreatic cancer, necessitating continued efforts in cost-effective care delivery and resource allocation.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003ePancreatic cancer is a devastating disease characterized by a poor 5-year survival rate and significant economic burdens for treatment. The key findings from our study reveal stable hospitalization rates, despite an increasing prevalence among certain demographic groups such as Hispanics. There is a higher incidence among males and a White population. The prevalence of several comorbidities associated with pancreatic cancer has shown an upward trend, highlighting ongoing challenges in managing these complex cases. Despite minor improvements in therapy and surgical methods, the inherently high cost of chemotherapy exacerbates the economic burden. It is important to identify the related risk factors and populations that are at a high risk, in addition to achieving early diagnosis based on clinical examinations or biomarkers.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAHRQ\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAgency for healthcare research and quality\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCOPD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eChronic obstructive pulmonary disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDischarge\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHome health\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHTN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHCUP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHealthcare cost and utilization project\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLOS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003elength of stay\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNIS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNationwide Inpatient Sample\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePUD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePeptic ulcer disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePVD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePeripheral vascular disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSNF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSkilled nursing facility\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSTF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eShort term facility\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTHC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003etotal hospital costs\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003eInstitutional Review Board Approval: Not needed as the data has been collected from public databases.\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate: Not applicable.\u003c/p\u003e\n\u003cp\u003eConsent for publication: Not applicable.\u003c/p\u003e\n\u003cp\u003eFinancial Disclosures/Funding: Not applicable.\u003c/p\u003e\n\u003cp\u003eInformed Consent: Not applicable\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eSC, as the first author collected articles, generated tables, wrote most of the sections, and was a major contributor to writing the manuscript. ET and AY as a second and third author gathered relevant articles and contributed to the discussion section of the manuscript. NV as a senior author reviewed the article and made necessary changes to the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePark W, Chawla A, O'Reilly EM. Pancreatic Cancer: A Review. JAMA. 2021;326(9):851\u0026ndash;862. doi: 10.1001/jama.2021.13027. Erratum in: JAMA. 2021;326(20):2081. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jama.2021.19984\u003c/span\u003e\u003cspan address=\"10.1001/jama.2021.19984\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. [PubMed] [Google Scholar]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGBD 2017 Pancreatic Cancer Collaborators. 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[PubMed] [Google Scholar]\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Pancreatic cancer, Trends, Cancer, Mortality, Comorbidities, Hospitalizations","lastPublishedDoi":"10.21203/rs.3.rs-6131810/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6131810/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Pancreatic cancer remains one of the deadliest cancers with rising mortality and incidence rates worldwide. This study analyzes recent trends in pancreatic cancer to understand the demographic and temporal shifts in its outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A retrospective cohort study was conducted using Nationwide Inpatient Sample (NIS) database from 2016 until 2020, to identify pancreatic cancer hospitalization, discharges, and investigate outcomes. Trends were adjusted for age, sex, race, insurance type, mean household income, and hospital characteristics. Multivariable logistic regression has been used to analyze the data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e A total of 103,588,729 records were analyzed, identifying 111,250 cases with a diagnosis of pancreatic cancer. From 2016 to 2020, hospitalizations remained relatively stable, with a slight decrease from 37,434 to 36,510. The mean age at diagnosis was 68 years (P\u0026lt;0.001). Males were slightly more affected than females. The highest prevalence was observed in the White population (70%), followed by African Americans (13.9%) and Hispanics (8.3%) (P\u0026lt;0.001). Notably, the prevalence among Hispanics increased from 8.3% to 9.1%, (P\u0026lt;0.001). Inpatient mortality decreased from 6.9% to 4.9% (P\u0026lt;0.001), and the mean hospital stay reduced from 7.1 to 6.8 days. However, hospital charges increased from $88,778 to $100,278.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Risk factors include male sex, with the mean age at diagnosis being 68 years. The incidence among the Hispanic population has been increasing over the years. Although inpatient mortality has decreased, this may be due to terminally ill patients opting for end-of-life care at home or in hospice, which is not recorded in the database.\u003c/p\u003e","manuscriptTitle":"Shifting Patterns in Pancreatic Cancer- Trends in Hospitalizations in U.S.A","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-18 11:15:44","doi":"10.21203/rs.3.rs-6131810/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9b08eeda-1a4e-4f89-b57d-8e3e049446fc","owner":[],"postedDate":"March 18th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-27T08:09:04+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-18 11:15:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6131810","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6131810","identity":"rs-6131810","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}