Comparison of clinical outcomes between non-invasive ventilation and high-flow nasal cannula use in patients with acute pancreatitis

BACKGROUND: Noninvasive ventilation (NIV) and high-flow nasal cannula (HFNC) are widely used respiratory support strategies, but their comparative effectiveness in acute pancreatitis remains unclear. Therefore, we analyzed clinical outcomes associated with these interventions using the National Inpatient Sample database (2016–2022). METHODS: This retrospective study compared clinical outcomes between patients treated with NIV and those treated with HFNC, focusing on mortality, intubation rates, complications, length of stay (LOS), and healthcare costs. We conducted univariate and multivariate logistic regression analyzes, adjusting for patient demographics, hospital characteristics, and comorbidities. RESULTS: HFNC treatment was associated with higher mortality (25.7% vs. 15.9%), intubation rates (39.1% vs. 23.6%), and pulmonary complications (pneumonia: 35.2% vs. 23.9%; pulmonary embolism: 6.6% vs. 2.8%) compared to NIV. patients receiving HFNC had longer hospital stays (20.38 vs. 13.62 days) and incurred higher healthcare costs ($302,387.31 vs. $198,870.53) (all P < 0.001). CONCLUSION: In this retrospective analysis, initial management with NIV was associated with better clinical outcomes and reduced healthcare resource utilization compared to HFNC in patients with acute pancreatitis. These findings warrant validation in prospective studies.