A0001 - Opiate Use Is Associated With Increased Risk of Post ERCP Pancreatitis: A National Cohort Study

Sunday, October 23, 2022

5:00 PM – 7:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

ET

Eric O. Then, MD

The Brooklyn Hospital Center
Brooklyn, New York

Eric O. Then, MD¹, Jamil Shah, MD¹, Tyler Grantham, MD², Ahmed Abomhya, MD¹, Giovannie Isaac-Coss, MD¹, Vijay Gayam, MD¹, Praneeth Bandaru, MD¹, Denzil Etienne, MD¹, Madhavi Reddy, MD¹, Vinaya Gaduputi, MD³
¹The Brooklyn Hospital Center, Brooklyn, NY; ²Staten Island University Hospital, Staten Island, NY; ³Blanchard Valley Health System, Findlay, OH

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has evolved as a valuable tool in therapeutic management of pancreatobiliary disorders but is associated with a range of significant complications, the most common being post-ERCP pancreatitis (PEP). The aim of this study was to elucidate the impact of opiate use on the development and severity of post-endoscopic retrograde cholangiopancreatography. Pancreatitis (PEP).

Methods: We retrospectively analyzed patients who were hospitalized in 2017 using the national inpatient sample (NIS) database who underwent endoscopic retrograde cholangiopancreatography (ERCP) (via ICD-10 procedure codes). Our study group consisted of patients who had a secondary diagnosis of opiate use, and our control group consisted of patients who did not have a secondary diagnosis of opiate use. Our primary end point was to elucidate if the presence of opiate use increased the risk of developing post-ercp pancreatitis. Additionally, we assessed if opiate use worsened outcomes in patients who underwent ERCP. We accomplished this by extracting variables such as length of hospital stay (LOS), total hospital charges and in hospital mortality rates. Categorical variables were compared using the chi-square test, and continuous variables were compared using t-test. Multivariate regressions models and all statistical analysis were performed using STATA 16 software.

Results: A total of 172,255 patients who underwent ERCP were identified, of which 2,120 were opiate users. Opiate users were hospitalized at a younger age when compared to opiate non-users (53.7 years vs 60.5 years; p-value: < 0.01), had a longer length of hospital stay (8.3 days vs 6.0 days; p-value: < 0.01), total hospital charges ($102,469 vs $82,191; p-value: < 0.01) and higher incidence of PEP (4% vs 2.7%; p-value: < 0.01).

Discussion: Opiate use is associated with younger age of presentation, increased LOS, total hospital charges, and increased frequency of PEP amongst patients undergoing ERCP. Further investigation is needed to assess the extent to which chronic opiate use may be a risk factor for post-ERCP pancreatitis and worse outcomes. If so, discontinuation of opiates before ERCP may be reasonable when possible.

	Opiate Use (N=2,120)	No Opiate Use (N=170,135)	P-value
Age of presentation	53.7	60.5	< 0.01
LOS (days)	8.3	6.0	< 0.01
Total charges (USD)	$102,469	$82,191	0.087
Died	35 (1.6%)	2,520 (1.4%)	0.525
PEP	85 (4%)	4,740 (2.7%)	< 0.01

LOS: Length of hospital stay; USD: United States Dollar; PEP: Post-ERCP Pancreatitis

Table: Table 1. Hospital outcomes in opiate users vs non-users undergoing ERCP

Disclosures:

Eric Then indicated no relevant financial relationships.

Jamil Shah indicated no relevant financial relationships.

Tyler Grantham indicated no relevant financial relationships.

Ahmed Abomhya indicated no relevant financial relationships.

Giovannie Isaac-Coss indicated no relevant financial relationships.

Vijay Gayam indicated no relevant financial relationships.

Praneeth Bandaru indicated no relevant financial relationships.

Denzil Etienne indicated no relevant financial relationships.

Madhavi Reddy indicated no relevant financial relationships.

Vinaya Gaduputi indicated no relevant financial relationships.

Eric O. Then, MD¹, Jamil Shah, MD¹, Tyler Grantham, MD², Ahmed Abomhya, MD¹, Giovannie Isaac-Coss, MD¹, Vijay Gayam, MD¹, Praneeth Bandaru, MD¹, Denzil Etienne, MD¹, Madhavi Reddy, MD¹, Vinaya Gaduputi, MD³. A0001 - Opiate Use Is Associated With Increased Risk of Post ERCP Pancreatitis: A National Cohort Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.