D0681 - Peptic Ulcer Disease in Non-Alcoholic Fatty Liver Disease (NAFLD) Hospitalizations: Identifying National Trends in the United States

Dushyant S. Dahiya, MD¹, Amandeep Singh, MD², Hassam Ali, MD³, Vinay Jahagirdar, MBBS⁴, Abhilash Perisetti, MD⁵, Rajat Garg, MD², Sailaja Pisipati, MBBS, FRCS⁶, Manik Aggarwal, MD², Haseeb Mohideen, MD⁷, Sumant Inamdar, MD, MPH⁸, Mohammad Al-Haddad, MD, MSc⁷, Madhusudhan Sanaka, MD^9
1Central Michigan University College of Medicine, Saginaw, MI; ²Cleveland Clinic Foundation, Cleveland, OH; ³East Carolina University, Greenville, NC; ⁴University of Missouri Kansas City School of Medicine, Kansas City, MO; ⁵Parkview Cancer Institute, Fort Wayne, IN; 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: Nonalcoholic fatty liver disease (NAFLD) is rapidly emerging as one of the most common causes of chronic liver disease worldwide and in the United States (US), primarily secondary to the obesity epidemic, rising prevalence of diabetes mellitus, and an aging population. Although peptic ulcer disease (PUD) is commonly seen in patients with liver cirrhosis, there is a lack of data on PUD in patients with NAFLD. In this study, we aimed to identify trends of PUD in NAFLD hospitalizations in the US.

Methods: This retrospective study utilized the National Inpatient Sample to identify all NAFLD hospitalizations with PUD in the US from 2009 to 2019. Trends of hospitalization characteristics and clinical outcomes were highlighted. P-values ≤0.05 were considered statistically significant.

Results: Overall, the total number of NAFLD hospitalizations with PUD increased from 3,745 in 2009 to 3,805 in 2019, after an initial peak from 2009 to 2014 and a decline until 2016 (Table 1). NAFLD hospitalizations with PUD were primarily at large urban teaching hospitals. The mean age of the study cohort increased from 56 years in 2009 to 63 years in 2019 (p-trend< 0.001). Additionally, only the 65–79 age group with NAFLD had a rising trend of PUD from 26% in 2009 to 46% in 2019 (p-trend< 0.001) [Figure 1]. Racial differences were also prevalent as we noted a rising trend of White and Hispanic NAFLD hospitalizations with PUD; however, a decline was observed for Blacks and Asians (Table 1). Trends of H. Pylori infection and upper endoscopy decreased from 5% in 2009 to 1% in 2019 (p-trend< 0.001) and 60% in 2009 to 19% in 2019 (p-trend< 0.001), respectively. Furthermore, we noted an increase in inpatient mortality from 2% in 2009 to 5% in 2019 (p-trend< 0.001). The mean length of stay increased from 5.5 days in 2009 to 7.2 days in 2019 (p-trend< 0.001), and the mean inpatient charge from $41,474 in 2009 to $92,354 in 2019 (p-trend< 0.001).

Discussion: Literature reports a decrease in the incidence, prevalence, and hospitalization rates of PUD in the US. This study noted an overall increase in PUD in NAFLD hospitalizations. Furthermore, inpatient mortality also increased to 5% in 2019, the exact reason for which is currently unknown. However, we noted a decrease in the trends of H. Pylori infection and upper endoscopy for NAFLD hospitalizations with PUD. Additional prospective studies are needed to fully understand PUD trends in NAFLD populations.




Disclosures:


Dushyant S. Dahiya, MD¹, Amandeep Singh, MD², Hassam Ali, MD³, Vinay Jahagirdar, MBBS⁴, Abhilash Perisetti, MD⁵, Rajat Garg, MD², Sailaja Pisipati, MBBS, FRCS⁶, Manik Aggarwal, MD², Haseeb Mohideen, MD⁷, Sumant Inamdar, MD, MPH⁸, Mohammad Al-Haddad, MD, MSc⁷, Madhusudhan Sanaka, MD⁹. D0681 - Peptic Ulcer Disease in Non-Alcoholic Fatty Liver Disease (NAFLD) Hospitalizations: Identifying National Trends in the United States, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.