Rowan University School of Osteopathic Medicine, Jefferson Health NJ Voorhees Township, NJ, United States
Neethi R. Dasu, DO1, Yaser Khalid, DO2, Donald J. McMahon, DO3, C Jonathan Foster, DO4, Brian Blair, DO5 1Rowan University School of Osteopathic Medicine, Jefferson Health NJ, Voorhees Township, NJ; 2Wright Center for Graduate Medical Education, Davie, FL; 3Thomas Jefferson University Hospital, Turnersville, NJ; 4Thomas Jefferson University Hospital, Cherry HIll, NJ; 5Thomas Jefferson University, Cherry HIll, NJ
Introduction: Although there have been only a few studies, non-alcoholic fatty liver disease (NAFLD) was identified as an important risk factor for complications following endoscopic retrograde cholangiopancreatography (ERCP). There are minimal studies on the influence of sex, race, insurance status on mortality, hospital length of stay (LOS), and total hospital charges for patients with NAFLD undergoing ERCP. The objective of this study was to identify risk factors in a national population cohort (in the USA) admitted to hospital from the year 2012-2018.
Methods: All patients aged 18 years and above with NAFLD undergoing ERCP were identified from the US Nationwide Inpatient Sample (NIS), a large publicly available all-payer inpatient care database in the USA. Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, the average length of hospital stay, and hospital charges, after adjusting for age, gender, race, primary insurance payer status, hospital type and size (number of beds), hospital region, hospital teaching status, and other demographic characteristics.
Results: Our study identified approximately 53,417 patients who had been discharged with NAFLD who underwent an ERCP and patients without NAFLD who underwent an ERCP from 2012-2018. The average age was 54.88 and 9,793 were admitted with NAFLD and underwent ERCP versus 43,624 without NAFLD who underwent ERCP. The analysis revealed that differences in mortality [OR 0.30 (0.23-0.39), p< 0.0001] and length of stay (OR 0.96 (0.95-0.97), p< 0.0001), p < 0.058 ) were statistically significant, but total hospital charges [OR 1.00 (0.90-1.10), p< 0.0001)] were not statistically significant for patients with NAFLD who underwent ERCP. Positive predictors for mortality for patients with NAFLD undergoing ERCP were the following: black ethnicity [OR 2.26 (1.03-4.94), p< 0.04], hispanic ethnicity [OR 0.23 (0.07-0.80), p< 0.0020], ascites [OR 5.16 (2.50-10.67), p< 0.0001], variceal bleeding [OR 4.69 (1.74-12.60), p< 0.002], acute liver failure [OR 13.11 (4.04-42.50), p< 0.0001], and respiratory failure [OR 6.60 (2.40-18.12), p< 0.0001].
Discussion: Patients with NAFLD and ERCP had higher mortality and LOS compared to patients without NAFLD who underwent ERCP. This is an important study because it identifies NAFLD as an important risk factor for increased morbidity and mortality in this patient population.
Neethi Dasu indicated no relevant financial relationships.
Yaser Khalid indicated no relevant financial relationships.
Donald McMahon indicated no relevant financial relationships.
C Jonathan Foster indicated no relevant financial relationships.
Brian Blair indicated no relevant financial relationships.
Neethi R. Dasu, DO1, Yaser Khalid, DO2, Donald J. McMahon, DO3, C Jonathan Foster, DO4, Brian Blair, DO5. P1703 - Post Endoscopic Retrograde Cholangiopancreatography (ERCP) Complications in Patients With NAFLD: An Analysis of the National Inpatient Sample 2012- 2018, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.