P1702 - Postprocedural Complications in Patients With Primary Sclerosing Cholangitis (PSC) Undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP)

Neethi R. Dasu, DO¹, Yaser Khalid, DO², C Jonathan Foster, DO³, Donald J. McMahon, DO^4
1Rowan University School of Osteopathic Medicine, Jefferson Health NJ, Voorhees Township, NJ; ²Wright Center for Graduate Medical Education, Davie, FL; ³Thomas Jefferson University Hospital, Cherry HIll, NJ; ⁴Thomas Jefferson University Hospital, Turnersville, NJ

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) plays a significant role in both diagnosing and evaluating the complications of PSC due to its high accuracy and prognostic value. The objective of this study was to identify risk factors in a national population cohort admitted to hospitals in the years 2012- 2018.

Methods: All patients aged 18 years and above with PSC undergoing ERCP were identified from the US Nationwide Inpatient Sample (NIS). Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, the average length of hospital stay, and hospital charges, after adjusting for age, gender, race, primary insurance payer status, hospital type and size (number of beds), hospital region, hospital teaching status, and other demographic characteristics

Results: Our study identified approximately 235,794 patients who had been discharged with either PSC undergoing ERCP versus without PSC undergoing ERCP from 2012- 2018. Of these patients, the average age was 67 and 33,114 were admitted with PSC and underwent ERCP versus 202,680 patients without PSC undergoing ERCP. The analysis revealed that increases in mortality [OR 2.71 (2.52-2.92), p< 0.0001] , length of stay [OR 1.02 (1.01-1.03), p< 0.0001] were all statistically significant but there was no statistically significant difference in total hospital charges [OR 1.00 (1.00-1.01), p< 0.001 ] for patients with PSC and ERCP. Positive predictors for mortality with patients with PSC undergoing ERCP included: black race [OR 1.95 (1.59-2.38), p< 0.0001 ], other race [ OR 1.48 (1.08-2.03), p< 0.014], ascites [OR 63 (2.99-4.42), p< 0.0001], HRS [OR 5.96 (3.83-9.24), p< 0.0001 ], variceal bleeding [ OR 2.04 (1.48-2.79), p< 0.0001], post-procedural bleeding [OR 1.72 (1.17-2.54), p< 0.006], acute liver failure [OR 4.37 (2.93-6.53), p< 0.0001], and respiratory failure [ OR 3.15 (2.25-4.42), p< 0.0001].

Discussion: Patients with PSC and ERCP had higher mortality and LOS compared to patients without PSC who underwent ERCP. There are limited treatment options for PSC, ERCP has been an important tool for evaluating and treating patients with PSC but more studies are required to fully evaluate the safety of ERCP for patients with PSC. This is an important study that highlights the potentially detrimental complications of ERCP and highlights the need for endoscopists to be vigilant in recognizing patients in this population.


Disclosures:


Neethi R. Dasu, DO¹, Yaser Khalid, DO², C Jonathan Foster, DO³, Donald J. McMahon, DO⁴. P1702 - Postprocedural Complications in Patients With Primary Sclerosing Cholangitis (PSC) Undergoing Endoscopic Retrograde Cholangiopancreatography (ERCP), ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.