Achint Patel, MD, MPH1, Hardikkumar Shah, MD, MPH2, Mohammed Mustafa Hasan, MD3, Harmanpreet Kaur, MBBS4, Yashwitha Sai Pulakurthi, MBBS5, Praneeth Reddy Keesari, MBBS6, Swathy Chirindoth, MBBS7, Uvesh Mansuri, MD, MPH8, Joseph DePasquale, MD9; 1Sayre, PA; 2Saint Michael's Medical Center, Newark, NJ; 3Internal Medicine & Family Practice, Joliet, IL; 4Bramalea & Bovaird Walk-In Clinic, Brampton, ON, Canada; 5WellStar Atlanta Medical Center, Atlanta, GA; 6University of Chicago, Chicago, IL; 7Kannur Medical College, Kannur, Kerala, India; 8MedStar Union Memorial Hospital, Baltimore, MD; 9Jersey City Medical Center, Jersey City, NJ
Introduction: Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder leading to multiple hospitalizations and causes significant impairment to the quality of life. We aim to study the trends, characteristics and outcomes of CVS using a nationwide database. Methods: We derived a study cohort from the Nationwide Inpatient Sample (NIS) for the years 2008-2017. Hospitalizations due to CVS were identified using International Classification of Diseases (9th/10th Editions) Clinical Modification diagnosis codes (ICD-9-CM/ICD-10-CM). Comorbidities were also identified by ICD-9/10-CM codes and Elixhauser comorbidity software. Our primary outcome was discharge to the facility following CVS hospitalization. We utilized multivariable survey logistic regression models to analyze the outcomes and identify predictors. Results: A total 229,586 were patients hospitalized due to CVS during the study period. Number of hospitalizations due CVS decreased from 18,032 in 2008 to 17,420 in 2017. Among the hospitalised patients 24% were < 18 years, 62% females and 66% caucasians. Mean Length of Stay(LOS) of hospitalized patients was 3.21±0.02 days. Out of total hospitalizations, 5.75% were discharged to facilities and 0.29% died during hospitalization. Furthermore, in multivariable regression analysis, younger age < 18 years (OR 2.0; 95%CI 1.6-2.5; p< 0.0001), Rural/non-teaching hospital (OR 2.2; 95%CI 1.9-2.5; p< 0.001) and Small bed size hospitals (OR 1.4; CI 1.3-1.6; p< 0.0001) and pre existing comorbidities such as Hypothyroidism (OR 1.1; 95%CI 1.0-1.3; p=0.029), Psychiatric Disorders (OR 2.1; 95%CI 1.8-2.6; p< 0.0001) and depression (OR 1.2; 95%CI 1.1-1.4; p=0.005) were associated with higher odds of discharge to the facility. Moreover in-hospital complications like septicemia, CHF, renal failure, were also associated with poor outcomes. However, patients with private insurance had decreased odds of discharge to a facility. Discussion: We observed that hospitalisations due to CVS have declined over years. We delineated several predictors and comorbidities that have been associated with adverse outcomes, especially in the pediatric population. Efforts to mitigate comorbid conditions and modifiable predictors to reduce healthcare utilization are warranted.
Disclosures: Achint Patel indicated no relevant financial relationships. Hardikkumar Shah indicated no relevant financial relationships. Mohammed Mustafa Hasan indicated no relevant financial relationships. Harmanpreet Kaur indicated no relevant financial relationships. Yashwitha Sai Pulakurthi indicated no relevant financial relationships. Praneeth Reddy Keesari indicated no relevant financial relationships. Swathy Chirindoth indicated no relevant financial relationships. Uvesh Mansuri indicated no relevant financial relationships. Joseph DePasquale indicated no relevant financial relationships.