P2122 - Factors Associated With Post Endoscopic Retrograde Cholangiopancreatography Pancreatitis in Obese Patients

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, MD^11
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, 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.