B0280 - Trainee Effects on Upper Endoscopy-Related Adverse Outcomes in the Months of July-September: An Analysis of National Inpatient Sample Database

Karthik Gangu, MD¹, Harleen K. Chela, MD², Mustafa H. Gandhi, MD², Alhareth Al Juboori, MD³, Hamza Ertugrul, MD¹, Aniesh Bobba, MD⁴, Ebubekir Daglilar, MD^1
1University of Missouri, Columbia, MO; ²University of Missouri-Columbia, Columbia, MO; ³University of Missouri-Columbia, Scottsdale, AZ; ⁴John H. Stroger, Jr. Hospital of Cook County, Chicago, IL

Introduction: Trainees early in their career are on the path to acquiring new knowledge and skills & this applies to all fields of work including gastroenterology. As fellows begin the journey in navigating realm of endoscopy, they are prone to inadvertently making mistakes. Aim of our study is to evaluate differences in outcomes of upper endoscopies performed before and after new trainees join programs across the nation.

Methods: Retrospective study utilizing the 2016 to 2018 National inpatient sample, and we included patients aged 18 or older who underwent upper endoscopy during hospitalization at teaching hospitals. We excluded patients who were admitted from January-March and October-December, transferred from another facility & admitted to non-teaching hospitals. Procedural complications, all cause in hospital mortality, length of stay (LOS), hospitalization cost was compared between early academic months (July-September) to late academic months (April-June). Multivariate logistic regression model was used to for procedural complications, all-cause mortality and linear regression was used for the analysis of LOS and hospitalization cost.

Results: Total sample size attained was 911,235 upper endoscopies performed and nearly comparable percentages of these were performed in the months of July-September and April-June. No significant difference in age of patients in these two groups and neither for gender. Majority of patients in both groups were Caucasian but distribution of races between the two groups was not significant. Medicare was predominant form of insurance in these patients but distribution was not significant. Procedure related complications such as aspiration, bleeding, accidental puncture/laceration, were not statistically different between the two groups. However, in-hospital all-cause mortality, cost of hospitalization, length of stay were all significantly higher in group with upper endoscopies performed between months of July-September. Adjusted odds ratio for in-hospital mortality was 1.09 (95% CI 1.01-1.17).

Discussion: Upper endoscopy related 3 major adverse events were not different in both groups likely as a result of adequate procedural supervision. Our study showed that there was a significant increase in cost, length of hospitalization, all-cause mortality in upper endoscopies that were performed in the months of July-September when new trainees enter residency and fellowship. Further measures may be needed to improve these outcomes early on, though some may be unavoidable.



Disclosures:


Karthik Gangu, MD¹, Harleen K. Chela, MD², Mustafa H. Gandhi, MD², Alhareth Al Juboori, MD³, Hamza Ertugrul, MD¹, Aniesh Bobba, MD⁴, Ebubekir Daglilar, MD¹. B0280 - Trainee Effects on Upper Endoscopy-Related Adverse Outcomes in the Months of July-September: An Analysis of National Inpatient Sample Database, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.