B0319 - Outcomes of Difficult Airway (DA) Patients Presenting With Upper Gastrointestinal Bleed (UGIB): 4-Year Retrospective Study Using National Inpatient Sample (2016 – 2019)

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Sriram B. Chowdary, MD

Geisinger Health System
South Abington Township, PA

Sriram B. Chowdary, MD¹, Dhruv Lowe, MD¹, Abhinav Goyal, MD¹, Divey Manocha, MD¹, Soohwan Chun, MD², Kishore Kumar, MD¹, Birendra Amgai, MD¹
¹Geisinger Health System, Scranton, PA; ²Geisinger, Scranton, PA

Introduction: Difficult airway patients presenting with upper gastrointestinal bleeding present unique challenge due to increased risk of respiratory complications such as from aspiration or from airway obstruction during anesthesia for urgent upper endoscopy. Limited data are available regarding clinical outcomes in difficult airway patients presenting with Upper gastrointestinal bleed.

Methods: Using National Inpatient Sample databases from 2016 to 2019, we identified patients presenting with

Upper gastrointestinal bleed, the population were then divided based on the presence and absence of difficult airway using appropriate ICD-10-CM/PCS codes. STATA 17.0 software (3) was used for the analysis. Pearson’s Chi-Square test was used to analyze categorical variable, whereas the student t-test was used to analyze continuous variables. Univariate and multivariate logistic regression was used to adjust for potential confounders. Primary outcome was in hospital mortality due to upper gastrointestinal bleed in patients with and without difficult airway.

Results: Amongst total of 1555580 patients admitted with upper gastrointestinal bleed, 140 patients had diagnosis of difficult airway and 1555440 patients did not have difficult airway diagnosis, male gender and white ethnicity was predominant in both populations. The mean LOS was 6.035±5.02 days in difficult airway group, 4.288±4.45 in non-airway group, this result was statistically significant. The mean total hospitalization charges in difficult airway group were 27111$, in the non-difficult airway group were 13183$ and this was found to be statistically significant. There were 45(32.14%) and 36708(2.36%) mortality in patients with and without difficult airway diagnosis. The difference is statistically significant with OR:5.06, 95% CI: 1.62-15.81, and p < 0.001. Odds of using IR intervention and ICU admissions were higher and EGD were lower in difficult airway group, found to be statistically significant.

Discussion: Patient with diagnosis of difficult airway presenting with upper gastrointestinal bleed symptoms were younger, had higher healthcare utilization and were associated with higher inpatient mortality and complications.

Variables	Odds ratio	95% CI	P-value
In-patient mortality	5.06	1.62-15.81	< 0.001
ALL EGD	0.425	0.131-1.378	< 0.001
IR intervention	1.23	0.206-7.31	< 0.001
ICU Stay	34.641	13.61- 88.11	< 0.001
Blood Products Transfusion	0.935	0.408-2.14	< 0.001
Blakemore tube insertion	0.95	0.373-2.458	< 0.001

Table: In Patient Outcomes of the difficult intubation group presenting with upper gastrointestinal bleed

Disclosures:

Sriram Chowdary indicated no relevant financial relationships.

Dhruv Lowe indicated no relevant financial relationships.

Abhinav Goyal indicated no relevant financial relationships.

Divey Manocha indicated no relevant financial relationships.

Soohwan Chun indicated no relevant financial relationships.

Kishore Kumar indicated no relevant financial relationships.

Birendra Amgai indicated no relevant financial relationships.

Sriram B. Chowdary, MD¹, Dhruv Lowe, MD¹, Abhinav Goyal, MD¹, Divey Manocha, MD¹, Soohwan Chun, MD², Kishore Kumar, MD¹, Birendra Amgai, MD¹. B0319 - Outcomes of Difficult Airway (DA) Patients Presenting With Upper Gastrointestinal Bleed (UGIB): 4-Year Retrospective Study Using National Inpatient Sample (2016 – 2019), ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.