University of Kentucky College of Medicine LEXINGTON, KY
Reza A. Haider, MBA1, Mahmoud Hashim, MD2, Ahmed Elkheshen, MBBS3, Pradeep Yarra, MD4, Courtney Perry, DO, MS3, Mohammed Sabry, MBBS3, Bahaaeldeen Ismail, MD, MSc3; 1University of Kentucky College of Medicine, Lexington, KY; 2Baylor College of Medicine, Houston, TX; 3University of Kentucky, Lexington, KY; 4University of Kentucky College of Medcine, Lexington, KY
Introduction: Wound healing is known to be negatively impacted in obese patients via oxidative stress and altered vascularity, however the effect of obesity on gastric ulcer (GU) healing remains unknown. While some studies suggest higher incidence of GU with obesity, studies pertaining to the effect on healing are limited. This study aims to examine the effect of obesity on GU healing in a model accounting for other potential confounders of the healing process. Methods: After reviewing 180 charts of patients that underwent EGD for GU at a tertiary medical center between February 2014 and July 2018, 43 patients met the inclusion criteria of having endoscopic evidence of GU and a follow-up EGD (FU EGD) within 4 to 12 weeks of the initial EGD. Healing was defined endoscopically. Obesity was defined as BMI ≥ 30.0. Endoscopic, demographic, and clinical variables known to affect GU healing were extracted, then a multivariate logistic regression was performed to account for these covariates. Results: Out of the included 43 patients, 18 (42%) were obese (mean BMI = 36.2). In the obese group, 33% of patients demonstrated a healed GU at the FU EGD, compared to 64% of the non-obese group. All the included patients were adherent to PPIs. There was no statistically significant difference between the groups regarding age, vasculopathy (72% of obese versus 60% of non-obese), NSAID usage(36%, 44%), and smoking status (28%,40%), (Table 1). H. pylori status after the index endoscopy was available in 74% of our patients (16% positive of those tested). All those with confirmed H. pylori after index endoscopy were compliant with treatment. After univariate analysis, obesity and days between EGDs were included in the multivariate logistic regression model (to account for inconsistent time to repeat EGD), which showed a lower OR of healed ulcer in obese patients (0.26 [95% CI, 0.07-0.97]) (Table 2). Discussion: In our study, obesity was independently associated with delayed GU healing. This suggests a benefit of weight management in an obese patient population with GU. In conjunction with smoking cessation, NSAID avoidance, and PPI adherence, weight loss is a potential protective lifestyle modification against refractory GU. Further studies with larger samples and prospective design are required to confirm our findings.
*The first two authors contributed equally to this study.
Patient Demographic, Endoscopic, and Clinical Characteristics of Obese and Non-obese Groups.
Logistic Regression of Variables Predictive of Gastric Ulcer Healing.
Disclosures: Reza Haider indicated no relevant financial relationships. Mahmoud Hashim indicated no relevant financial relationships. Ahmed Elkheshen indicated no relevant financial relationships. Pradeep Yarra indicated no relevant financial relationships. Courtney Perry indicated no relevant financial relationships. Mohammed Sabry indicated no relevant financial relationships. Bahaaeldeen Ismail indicated no relevant financial relationships.