P0668 - Does BMI Affect Outcomes in Patients on GLP-1RA Undergoing Endoscopy via MAC Anesthesia: A Retrospective Cohort Study

Rabih Ghazi, MD¹, Karl Akiki, MD¹, Kimberly Tena Diaz, DO², Jaclyn Levendusky, BS³, Rasha Abi Radi Abou Jaoudeh, MD⁴, Apeksha Shah, MD⁵, Krysta Contino, MD⁶, Rachel Frank, MD⁷, Christina Tofani, MD, FACG⁸, Adib Chaaya, MD^9
1Cooper University Hospital, Philadelphia, PA; ²Cooper University Health Care, Camden, NJ; ³Cooper Medical School of Rowan University, Camden, NJ; ⁴Cleveland Clinic Foundation, Cleveland, OH; ⁵Digestive Health Institute at Cooper University Hospital, Mt. Laurel, NJ; ⁶Digestive Health Institute at Cooper University Hospital, Mount Laurel, NJ; ⁷Cooper University Hospital, Mt. Laurel, NJ; ⁸Digestive Health Institute at Cooper University Hospital, Camden, NJ; ⁹Cooper Health Gastroenterology, Camden, NJ

Introduction: Recent concerns have been raised regarding the safety of GLP-1RA in patients undergoing endoscopy due to a possible increased risk of aspiration from retained stomach contents, particularly with the widespread use of monitored anesthesia care (MAC). Obesity can potentially further increase that risk due to elevated intragastric pressure. However, data in this population subgroup remain limited. In this study, we evaluate the effect of body mass index (BMI) on the safety of endoscopy under MAC in patients taking GLP-1RAs.

Methods: This retrospective chart review included patients on GLP-1RA for diabetes or weight management who underwent EGD ± Colonoscopy between October 1, 2018, and October 1, 2023. Patients who discontinued GLP-1RA at least one week before the procedure and those with altered gastrointestinal anatomy were excluded from the study. Patients were divided in 3 groups based on their body mass index (BMI): group 1 (BMI < 30kg/m2), group 2 (BMI 30-40 kg/m2), and group 3 (BMI ≥40 kg/m2). The primary outcome was overall adverse events (AEs) rates. Outcomes were compared using Pearson's chi-square or Fisher’s exact test for categorical variables and Student’s t-test or Wilcoxon rank-sum test for continuous variables.

Results: A total of 135 patients were included in the study (51 in group 1, 61 in group 2, and 23 in group 3). Group 3 had a significantly lower mean age (p = 0.005) and a higher proportion of Mallampati Class III (p < 0.001) and ASA Class III (p = 0.012) compared to groups 1 and 2, and a higher proportion of lung disease compared to group 1 (p = 0.010). Additionally, group 2 had a lower proportion of gastroparesis than group 1 (p = 0.013) and a higher proportion of diabetes compared to group 3 (p = 0.013). Baseline characteristics were otherwise similar among all groups (Table 1). The three groups had comparable rates of overall AEs (11.8% vs 13.1% vs 8.7%; p = 0.855) and intra-procedure AEs (11.8% vs 13.1% vs 8.7%; p = 0.855), hypotension (11.8% vs 8.2% vs 0.0%; p = 0.231), and hypoxemia (3.9% vs 6.6% vs 8.7%; p = 0.695). No post-procedure AEs were observed in any group.

Discussion: The rates of intra-procedure AEs did not differ between the different BMI groups and did not confer any increased risk for post-procedure complications. Therefore, endoscopy under MAC anesthesia appears to be safe for patients taking GLP-1RAs irrespective of BMI class. Additional studies with larger cohorts are needed to confirm these findings.


Disclosures:


Rabih Ghazi, MD¹, Karl Akiki, MD¹, Kimberly Tena Diaz, DO², Jaclyn Levendusky, BS³, Rasha Abi Radi Abou Jaoudeh, MD⁴, Apeksha Shah, MD⁵, Krysta Contino, MD⁶, Rachel Frank, MD⁷, Christina Tofani, MD, FACG⁸, Adib Chaaya, MD⁹. P0668 - Does BMI Affect Outcomes in Patients on GLP-1RA Undergoing Endoscopy via MAC Anesthesia: A Retrospective Cohort Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.