Race and neighborhood factors influence clinical outcomes in children hospitalized with acute pancreatitis.

OBJECTIVES: Disparities impacting acute pancreatitis (AP) outcomes have been reported. Although racial/ethnic disparities are known in AP, geospatial disparities have been unexplored in pediatric AP. We aimed to investigate area level social determinant of health (SDOH) factors on pediatric AP outcomes. METHODS: This is a retrospective study of children hospitalized with AP over 5 years. Data including home addresses and zip codes were geocoded to determine area level factors for SDOH. Descriptive statistics were used to summarize overall sample and stratified by length of stay (LOS), AP severity, and complications. Significance tests were performed using high-dimensional fixed effects regression with multiway cluster-robust standard errors. RESULTS: A total of 242 encounters for 182 participants living in 160 different census tracts were included. Non-Hispanic Black (NHB) children were more likely to live in urban and more minority neighborhoods. Children living in more urban and minority neighborhoods had increased mean LOS, and AP severity. Increased mean LOS persisted in NHB children after adjusting for co-variates (p = 0.009). Abstract charges were higher in children with AP who live in poorer neighborhoods even after adjusting for co-variates (p = 0.048). CONCLUSIONS: Children hospitalized with AP living in minority and urban neighborhoods experience an increased LOS and complications. NHB children are more likely to live in urban and minority neighborhoods and have an increased mean LOS. Abstract charges are higher for children with AP who live in poorer neighborhoods.