P1701 - Outcomes of Endoscopic Retrograde Cholangiopancreatography (ERCP) in Non-ST Elevation Myocardial Infarction (NSTEMI) Patients – A National Inpatient Sample Study (2012-2018)

Neethi R. Dasu, DO¹, Yaser Khalid, DO², C Jonathan Foster, DO³, Donald J. McMahon, DO⁴, Kirti Dasu, BS⁵, Richard Walters, DO^3
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; ⁵Syarcuse University, Stratford, NJ

Introduction: There are minimal studies that evaluate the influence of sex, race, insurance status, hospital length of stay (LOS), mortality, and total hospital charges for patients with NSTEMI undergoing ERCP compared to patients without NSTEMI undergoing ERCP. The aim of this study was to identify risk factors in a national population cohort (in the USA) admitted to hospitals between 2012 through 2018.

Methods: All patients aged 18 years and above with and without NSTEMI who underwent ERCP , were identified from the US Nationwide Inpatient Sample (NIS), a large publicly available all-payer inpatient care database in the USA. 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 234,485 patients who had been discharged following either ERCP and NSTEMI or ERCP without NSTEMI. Of these patients, 1,632 were admitted with NSTEMI who required an ERCP versus 232,853 without NSTEMI who required ERCP. The analysis revealed that the average age was 75.5. For patients with NSTEMI who underwent ERCP, mortality [OR 7.51 (6.33-8.91), p< 0.0001] and length of stay (LOS) were increased (OR 1.03 (1.01-1.05), p< 0.0001]. Independent positive predictors of mortality for patients with NSTEMI who underwent ERCP were Hispanic race [OR 0.20 (0.05-0.89), p< 0.034] and the presence of ascites [OR 3.90 (1.35-8.05), p< 0.009] or variceal bleeding [ OR 3.34 (1.62-6.89), p< 0.001].

Discussion: Patients with NSTEMI who underwent ERCP have increased LOS and mortality compared to patients without NSTEMI who underwent ERCP. We identified key drivers for these outcomes. The safety of endoscopy after an acute coronary syndrome (ACS) is currently poorly characterized. In the future, more randomized clinical trials are required to compare patients with NSTEMI undergoing ERCP, especially the impact of therapeutic interventions for this patient population.





Disclosures:


Neethi R. Dasu, DO¹, Yaser Khalid, DO², C Jonathan Foster, DO³, Donald J. McMahon, DO⁴, Kirti Dasu, BS⁵, Richard Walters, DO³. P1701 - Outcomes of Endoscopic Retrograde Cholangiopancreatography (ERCP) in Non-ST Elevation Myocardial Infarction (NSTEMI) Patients – A National Inpatient Sample Study (2012-2018), ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.