C0694 - The Influence of Non-Alcoholic Fatty Liver Disease (NAFLD) on Peptic Ulcer Disease Hospitalizations: A Comparative Analysis in the United States

Dushyant S. Dahiya, MD¹, Abhilash Perisetti, MD², Hassam Ali, MD³, Vinay Jahagirdar, MBBS⁴, Amandeep Singh, MD⁵, Sailaja Pisipati, MBBS, FRCS⁶, Rajat Garg, MD⁵, Manik Aggarwal, MD⁵, Haseeb Mohideen, MD⁷, Sumant Inamdar, MD, MPH⁸, Madhusudhan Sanaka, MD⁹, Mohammad Al-Haddad, MD, MSc^7
1Central Michigan University College of Medicine, Saginaw, MI; ²Parkview Cancer Institute, Fort Wayne, IN; ³East Carolina University, Greenville, NC; ⁴University of Missouri Kansas City School of Medicine, Kansas City, MO; ⁵Cleveland Clinic Foundation, Cleveland, OH; ⁶Mayo Clinic, Scottsdale, AZ; ⁷Indiana University School of Medicine, Indianapolis, IN; ⁸University of Arkansas for Medical Sciences, Little Rock, AR; ⁹Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH

Introduction: The global age-adjusted standardized incidence and prevalence rates of peptic ulcer disease (PUD) have declined over the last few decades. Nonetheless, studies have reported higher rates of PUD and its complications in patients with chronic liver disease. However, there continues to be a significant paucity of data on the impact of non-alcoholic fatty liver disease (NAFLD) in patients with PUD. In this study, we aimed to determine the influence of NAFLD on PUD hospitalizations in the United States (US).

Methods: The National Inpatient Sample was utilized to identify all adult hospitalizations of PUD in the US from 2009–2019. The study population was sub-grouped based on the presence or absence of NAFLD. Hospitalization characteristics and outcomes were compared. P-values ≤0.05 were statistically significant.

Results: Between 2009–2019, there were 50,769 and 4,624,628 PUD hospitalizations with and without NAFLD, respectively. PUD hospitalizations with NAFLD had a lower mean age (58.6 vs 65.3%, p< 0.001) compared to non-NAFLD PUD hospitalizations. Racial differences were evident as we noted a higher proportion of Whites (72 vs 70%, p< 0.001) and Hispanics (13 vs 9%, p< 0.001) for PUD hospitalizations with NAFLD compared to the non-NAFLD PUD cohort (Figure 1). Additionally, PUD hospitalizations with NAFLD had a higher proportion of patients with Charlson Comorbidity Index (CCI) ≥3 (55 vs 49%, p< 0.001) compared to non-NAFLD PUD hospitalizations. Although we did not find a statistical difference in the rates of bleeding PUD and H. Pylori infection between the two groups, PUD hospitalizations with NAFLD had higher upper endoscopy utilization (49 vs 41%, p< 0.001) compared to the non-NAFLD PUD cohort. Interestingly, PUD hospitalizations without NAFLD had a higher proportion of patients with peptic ulcer perforation (5 vs 3%, p< 0.001) compared to the NAFLD cohort. Furthermore, we noted lower inpatient mortality (2 vs 3%, p=0.0004), mean length of stay [LOS] (5.8 vs 6.2 days, p< 0.001), and mean total healthcare charge [THC] ($58,970 and $63,500, p< 0.001) for PUD hospitalizations with NAFLD compared to those without NAFLD.

Discussion: Despite a higher proportion of patients with CCI≥3, PUD hospitalizations with NAFLD had lower inpatient mortality, mean LOS, and mean THC compared to the non-NAFLD PUD cohort. However, we noted increased utilization of upper endoscopy for PUD hospitalizations with NAFLD. Additional studies are needed to fully understand the impact of NAFLD on PUD populations.




Disclosures:


Dushyant S. Dahiya, MD¹, Abhilash Perisetti, MD², Hassam Ali, MD³, Vinay Jahagirdar, MBBS⁴, Amandeep Singh, MD⁵, Sailaja Pisipati, MBBS, FRCS⁶, Rajat Garg, MD⁵, Manik Aggarwal, MD⁵, Haseeb Mohideen, MD⁷, Sumant Inamdar, MD, MPH⁸, Madhusudhan Sanaka, MD⁹, Mohammad Al-Haddad, MD, MSc⁷. C0694 - The Influence of Non-Alcoholic Fatty Liver Disease (NAFLD) on Peptic Ulcer Disease Hospitalizations: A Comparative Analysis in the United States, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.