guthrie robert packer hospital Sayre, PA, United States
Harshil Shah, MD1, Olga Sviderskaya, MD2, Sushen Bhalla, MBBS3, Omar Elsayed, MD4, Mohamed Nadeem, MBBS5, Subash Ghimire, MD1, Tsujung Yang, MD6, Pavani Tangirala, MBBS7, Ruchir Goswami, MBBS, MPH8, Achint Patel, MD, MPH9, Hardikkumar Shah, MD, MPH10, Yana Cavanagh, MD11 1Guthrie Robert Packer Hospital, Sayre, PA; 2Millburn Medical Center, Millburn, NJ; 3Prime Care Medical Clinic, Dearborn, MI; 4Independant Researcher, Rochester, NY; 5Jackson Park Hospital, Chicago, IL; 6MultiCare Good Samaritan Hospital, Puyallup, WA; 7Kakatiya Medical College, Warangal, Telangana, India; 8Icahn School of Medicine at Mount Sinai, New York, NY; 9Icahn School of Medicine at Mount Sinai, Rochester, NY; 10St. Joseph's University Medical Center, Paterson, NJ; 11St. Joseph's Hospital and Medical Center, Paterson, NJ
Introduction: Acute Pancreatitis is a known post-ERCP complication. Studies have shown increased incidence of post-ERCP pancreatitis in obese patients. This has been attributed to chronic low grade inflammation in obese patients, decreased levels of anti-inflammatory cytokine adiponectin and mechanical trauma to peripancreatic fat leading to fat necrosis. Studies on factors associated with increased incidence of post-ERCP pancreatitis in obese patients is limited. In this study, we analyze factors associated with post-ERCP pancreatitis in obese patients from nationwide inpatient sample.
Methods: Study cohort is derived from the Nationwide Inpatient Sample (NIS) for the years 2007-2018. Adult obese patients undergoing ERCP were identified using previously validated ICD-9-CM/ICD-10-CM codes. Post-ERCP pancreatitis and other diagnoses of interest were also identified by ICD-9/10-CM codes as well. We then utilized multivariable survey logistic regression models to identify the factors associated with post-ERCP pancreatitis.
Results: We analyzed 279,620 ERCP procedures performed in obese patients. Mean age of the study cohort was 53-years, 68% were female, and 65% were Caucasians followed by 18% Hispanic. Out of total, 5636 (2%) developed post-ERCP pancreatitis. In multivariable regression analysis, age group 18-34 as compared to older (OR 1.3; 95 % CI 1.1-1.6; p = 0.02), Asians/Other ethnicity vs Caucasian (OR 1.3; 95 % CI 1.1-1.7; p = 0.03) and teaching hospitals were associated with higher rates of post-ERCP pancreatitis. However, Hispanics, non-teaching hospitals, West and South regions were associated with lower rates of post-ERCP pancreatitis. Post-ERCP pancreatitis was associated with higher odds of discharge to the facility (OR 1.5; 95 % CI 1.2-1.8; p < 0.01) but was not associated with higher in-hospital mortality (OR 0.6; 95 % CI 0.5-1.1; p = 0.45).
Discussion: In this nationally representative study with the data collected between 2007-2018, we found that younger age, Asian/Other ethnicity and hospital type were associated with higher rate of post-ERCP pancreatitis in obese patients undergoing ERCP. Post -ERCP pancreatitis was associated with poor discharge outcomes. Further studies are required for better risk stratification and prevent post-ERCP pancreatitis in high risk obese patient.
Disclosures:
Harshil Shah indicated no relevant financial relationships.
Olga Sviderskaya indicated no relevant financial relationships.
Sushen Bhalla indicated no relevant financial relationships.
Omar Elsayed indicated no relevant financial relationships.
Mohamed Nadeem indicated no relevant financial relationships.
Subash Ghimire indicated no relevant financial relationships.
Tsujung Yang indicated no relevant financial relationships.
Pavani Tangirala indicated no relevant financial relationships.
Ruchir Goswami indicated no relevant financial relationships.
Achint Patel indicated no relevant financial relationships.
Hardikkumar Shah indicated no relevant financial relationships.
Yana Cavanagh indicated no relevant financial relationships.
Harshil Shah, MD1, Olga Sviderskaya, MD2, Sushen Bhalla, MBBS3, Omar Elsayed, MD4, Mohamed Nadeem, MBBS5, Subash Ghimire, MD1, Tsujung Yang, MD6, Pavani Tangirala, MBBS7, Ruchir Goswami, MBBS, MPH8, Achint Patel, MD, MPH9, Hardikkumar Shah, MD, MPH10, Yana Cavanagh, MD11. P2122 - Factors Associated With Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis in Obese Patients, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.