B0314 - Acute Gastrojejunal Ulcer With Hemorrhage: Nationwide Trends in Hospitalization, Demographic Disparity, Cost of Care, and Outcomes

Shantanu Solanki, MD, MPH¹, Khwaja S. Haq, MD², Dhanshree Solanki, MHA, MBA³, Anam S. Burney, MD⁴, Harshil Shah, MD⁵, Subash Ghimire, MD⁶, Asim Kichloo, MD⁷, Zarak Khan, MD⁸, Farah Wani, MD⁹, Ruhin Yuridullah, MD¹⁰, Dushyant S. Dahiya, MD⁷, Adil I. Memon, MD¹¹, Hafiz M. Khan, MD¹², Khwaja F. Haq, MD⁴, Syed-Mohammed Jafri, MD^13
1Trinitas Regional Medical Center, Hoboken, NJ; ²Wellstar Health System, Griffin, GA; ³Rutgers University, Hoboken, NJ; ⁴Stony Brook University Hospital, Stony Brook, NY; ⁵Guthrie Corning Hospital, Corning, NY; ⁶Guthrie Robert Packer Hospital, Sayre, PA; ⁷Central Michigan University College of Medicine, Saginaw, MI; ⁸Vidant Medical Center, Greenville, NC; ⁹Samaritan Medical Center, Watertown, NY; ¹⁰Saint Joseph's Health, Bloomfield, NJ; ¹¹Ochsner LSU Health Shreveport, Shreveport, LA; ¹²AdventHealth Orlando, Orlando, FL; ¹³Henry Ford Health System, Detroit, MI

Introduction: Complications at the gastrojejunal anastomosis after surgery can potentially be serious and even life threatening such as an acute gastrojejunal ulcer with hemorrhage (AGJUH). Limited epidemiological data exists on the number of hospitalizations, demographic variation, cost of care, comorbidity measures, and outcomes for AGJUH.

Methods: We analyzed the National Inpatient Sample (NIS) database for all hospitalizations with AGJUH (ICD-9 code 534.00 and ICD-10 code K28.0 as applicable) as primary or secondary diagnosis during the period from 2012-2018. NIS is the largest all-payer inpatient care database in the United States. Statistical significance of variation in the number of hospitalizations, demographic disparity, cost of care, comorbidity measures, and outcomes during the study period were determined using Cochran-Armitage trend test.

Results: Between 2012 and 2018, number of hospitalizations for AGJUH increased from 655 to 1,165 (p< 0.0001, figure 1A). Hospitalizations with AGJUH were found to be more common in women (p=0.0001) and Caucasians (p=0.0008). Although age group 45-64 remained the most affected, age group 65-84 showed the greatest rise from 29.0% to 32.6% (p< 0.0001, figure 1B). Generally, South remained the most affected region (p=0.01) throughout the study period. There was a significant rise in the Midwest from 13.7% to 20.6% (p=0.02) with a concurrent decrease in the Northeast from 29.0% to 20.2% (p=0.001). A proportional decrease in the number of hospitalizations was seen at both, urban non-teaching (38.2% to 22.3%, p< 0.0001, figure 1C) and rural hospitals (9.2% to 7.7%, p=0.005, figure 1C), while the number increased at urban teaching hospitals (52.7% to 70.0%, p< 0.0001, figure 1C). Mean length of hospital stay for AGJUH decreased from 7.0 ± 0.8 to 6.2 ± 0.4 days (p=0.34). Overall mortality decreased from 2.3% to 1.7% (p=0.09, figure 1D). Some of the most associated comorbid conditions with AGJUH were hypertension, fluid and electrolyte disorders, obesity, depression, and diabetes mellitus.

Discussion: A significant rise in the number of hospitalizations with AGJUH was found with interesting demographic variations and association with comorbidities. Decrease in length of hospital stays as well as overall mortality during the study period was likely due to increased use of newer, more advanced, diagnostic and treatment modalities. Further studies are needed to identify factors responsible for such trends to better elucidate our findings.



Disclosures:


Shantanu Solanki, MD, MPH¹, Khwaja S. Haq, MD², Dhanshree Solanki, MHA, MBA³, Anam S. Burney, MD⁴, Harshil Shah, MD⁵, Subash Ghimire, MD⁶, Asim Kichloo, MD⁷, Zarak Khan, MD⁸, Farah Wani, MD⁹, Ruhin Yuridullah, MD¹⁰, Dushyant S. Dahiya, MD⁷, Adil I. Memon, MD¹¹, Hafiz M. Khan, MD¹², Khwaja F. Haq, MD⁴, Syed-Mohammed Jafri, MD¹³. B0314 - Acute Gastrojejunal Ulcer With Hemorrhage: Nationwide Trends in Hospitalization, Demographic Disparity, Cost of Care, and Outcomes, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.