P4184 - Clinical Outcomes in Lower Gastrointestinal Bleeding for Patients Requiring Single vs Multiple Colonoscopies: An Analysis of the National Inpatient Sample 2016-2020

Christopher Chhoun, DO¹, Fanchen Zhou, MBA², Anudeep Jala, DO¹, Jason John, DO³, Neethi Dasu, DO⁴, Yaser Khalid, DO⁵, C. Jonathan Foster, DO⁶, Lucy Joo, DO^6
1Jefferson Health, Washington Township, NJ; ²University of Pennsylvania, New York, NY; ³Jefferson Health, Pennsauken, NJ; ⁴Beth Israel Lahey Health, Burlington, MA; ⁵Wright Center GME, Scranton, PA; ⁶Jefferson Health, Cherry Hill, NJ

Introduction: Lower GI bleeds account for about 20% of major GI bleeds. These patients may present with hematochezia and hemodynamic instability if the bleeding is brisk. The aim of this study was to investigate the outcomes of patients admitted to the hospital for lower GI bleeds who underwent multiple colonoscopies as compared to single colonoscopy. This study investigates mortality, average length of stay (LOS), and total hospitalization cost in these patients.

Methods: The National Inpatient Sample (NIS) database (2016-2020) was analyzed to identify adult patients admitted with ICD-10 CM/PCS codes for lower GI bleed patients who underwent single versus multiple colonoscopies. Multivariate logistic/linear regression analysis was used to estimate the odds ratios of mortality, LOS, and total hospitalization costs of lower GI bleed patients. Weighted analysis using Stata 17 MP was performed. Patient race, insurance status, age, gender and Charlson Comorbidity Index (CCI) were controlled in the regression analyses.

Results: Our study showed a significantly higher average mortality in patients who underwent multiple colonoscopies as compared to single colonoscopy(OR 1.42, CI 1.10-1.83, p-value< 0.01). In addition, average LOS was also significantly longer for patients with lower GI bleeds who underwent multiple colonoscopies by 3.24 days (OR 3.24, Cl 2.96-3.52, p< 0.0001). Our analysis also showed that the average total hospitalization charges were also significantly higher in patients with lower GI bleeds who underwent multiple colonoscopies (OR $39,808.8, CI $34,988.8-$44,628.9, p< 0.0001).

Discussion: Our study demonstrates that patients who are admitted to the hospital for lower GI bleed who underwent multiple treatments had significantly higher mortality rates, longer length of stay, and higher total hospitalizations costs. In terms of clinical significance, these findings suggest the need for a “second look” colonoscopy portends a significant difference in clinical outcomes. Further studies are warranted to develop strategies to optimize the clinical management of these patients.


Disclosures:


Christopher Chhoun, DO¹, Fanchen Zhou, MBA², Anudeep Jala, DO¹, Jason John, DO³, Neethi Dasu, DO⁴, Yaser Khalid, DO⁵, C. Jonathan Foster, DO⁶, Lucy Joo, DO⁶. P4184 - Clinical Outcomes in Lower Gastrointestinal Bleeding for Patients Requiring Single vs Multiple Colonoscopies: An Analysis of the National Inpatient Sample 2016-2020, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.