D0626 - Gastroenterology Consults Had Little Utility Prior to Transesophageal Echocardiograms in a Prospective Cohort Study

Award: Outstanding Research Award in the Practice Management Category (Trainee)

Award: Presidential Poster Award

Joseph Mizrahi, MD¹, Leslie Klyachman, MD¹, Anika Paradkar, MD¹, Eyal Menashe, MD¹, Jade Marhaba, MD¹, Daniel S. Jamorabo, MD^2
1Stony Brook University Hospital, Stony Brook, NY; ²Stony Brook Medicine, Stony Brook, NY

Introduction: Despite the low complication rate of Transesophageal Echocardiograms (TEE), the inpatient GI service is sometimes called to clear patients for a TEE when patients have active GI symptoms or a significant GI medical or surgical history. There is a paucity of data regarding whether the GI team is needed to evaluate such patients to prevent any complications from a TEE.

Methods: We performed a prospective cohort study of all inpatients who had a TEE ordered at our institution from 7/1/2021 through 5/31/2022. Patients’ demographic information, indications for TEE, complications from TEE, GI team recommendations, and the results of any interventions were collected. We also recorded 30-day readmission rates for all patients had a TEE ordered. We used Chi square analysis to compare categorical variables and t-tests to compare numerical variables.

Results: There were 502 patients who had a TEE ordered during our study period, of whom 442 (88%) underwent the procedure. Of the 60 (12%) who did not have a TEE, none were canceled due to a GI concern. There were 15/442 (3.4%) patients with complications from the TEE, none of which were GI-related. The GI team was consulted on 15/442 (3.4%) patients overall (Table 1), and cleared 8/15 (53.3%) with no further testing. Of the 7/15 (46.7%) patients on whom the GI service ordered imaging or endoscopic evaluation, all the workup was normal and all 7/7 underwent a TEE with no complications, though their length of stay was extended by an average of 3.6 days. There were 2/15 (13.3%) patients who were readmitted within 30 days, neither of which was for an upper GI etiology or that would have been prevented by an EGD.

Discussion: This is the first prospective study aimed at determining whether a GI consult prior to a TEE prevented any complications. In our analysis, there were no GI-related complications of any TEE that a preceding GI consult could have prevented, and the involvement of the inpatient GI team often led to unnecessary procedures and increased length of stay. Future plans include the creation of a risk stratification tool for inpatients planned for TEE to help identify individuals who could benefit most from a GI team consultation and thereby prevent inefficiencies in clinical care.



Disclosures:


Joseph Mizrahi, MD¹, Leslie Klyachman, MD¹, Anika Paradkar, MD¹, Eyal Menashe, MD¹, Jade Marhaba, MD¹, Daniel S. Jamorabo, MD². D0626 - Gastroenterology Consults Had Little Utility Prior to Transesophageal Echocardiograms in a Prospective Cohort Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.