St. Luke's University Hospital Easton, PA, United States
Nishit Patel, MD1, Kirtenkumar Patel, MD2, Nishi Patel, PharmD3, Mina Aiad, DO4 1St. Luke's University Hospital, Easton, PA; 2North Shore Medical Center, Manhasset, NY; 3University of South Carolina, Columbia, SC; 4St. Luke's University Hospital, Bethlehem, PA
Introduction: Pyloric stenosis is known to be more common in male than female infants. However, relatively little is known about the differences between males and females with Adults Hypertrophic Pyloric Stenosis (AHPS). This study aimed to evaluate the differences in the need for surgical management and outcomes between male and female patients with AHPS.
Methods: We performed a retrospective cohort study of the National Inpatient Sample (NIS). Inclusion criteria included the diagnosis of AHPS using the ICD-10-CM Code, admitted from Oct 2005 to Dec 2015 with the exclusion of patients < 18 years old. We used the SAS 9.4 software to run the analysis. The primary outcome was to assess the rate of surgical management in the male versus female group. The secondary outcomes were (1) type of procedure performed, (2) length of stay, (3) total hospitalization cost, and (4) in-hospital mortality between the two groups. Confounding factors including age, race, and insurance type were adjusted for using multivariate regression analysis.
Results: A total of 272,070 met the inclusion criteria, 151,683 (55.7%) were female and 120,386 (44.3%) were male patients. Mean age of 64.2 ± 16.9 and 63.7 ± 15.9 in females and males, respectively. Most of the patients were Caucasians (white), 98,168 (64.7%) of females versus 73,490 (61%) of males, and more than half of the total patients had Medicare insurance (54.9% of females versus 52.9% of males). The rate of surgical intervention was reported higher in females as compared to males (34.3% vs 28.4%, p< 0.0001). Pyloroplasty was the most common procedure performed, followed by partial gastrectomy and gastrostomy. Although the average length of stay and total hospitalization cost was higher in males (10.7 days and $23,601) than females (9.5 days and $20,466), the differences are statistically but not clinically significant. However, the in-hospital mortality in patients with AHPS were significantly higher in males (7,635 = 6.3%) than females (7,342 = 4.8%).
Discussion: Pyloric stenosis is more common in male infants than females, however, in the adult population, AHPS is reported higher in females as compared to males. As per our study, female patients with AHPS reported more surgical treatment than males. However, the in-hospital mortality – as well as the length of stay and total hospitalization cost - were higher in male patients.
Figure: Surgical procedures and outcomes in patients with AHPS.
Disclosures: Nishit Patel indicated no relevant financial relationships. Kirtenkumar Patel indicated no relevant financial relationships. Nishi Patel indicated no relevant financial relationships. Mina Aiad indicated no relevant financial relationships.
Nishit Patel, MD1, Kirtenkumar Patel, MD2, Nishi Patel, PharmD3, Mina Aiad, DO4. P3073 - Assessment of Gender Disparity in Outcomes of Adult Hypertrophic Pyloric Stenosis: A Nationwide Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.
