P1053 - Prevalence and Impact of Prior Bariatric Surgery Status on ERCP Outcomes in Older Patients with Obesity: A Population-Based Analysis

Boney Lapsiwala, MD¹, Pranav Chalasani, MD², Rishika Trivedi, MD³, Sahiljot Bhupal, MBBS⁴, Amrutha Yalla, MBBS⁵, Sahana Bopparaju, ⁶, Shreyans Doshi, MD⁷, Rupak Desai, MBBS^8
1Medical City Arlington, Denton, TX; ²Wayne State University School of Medicine / Ascension Providence Rochester Hospital, Rochester, MI; ³DHR Health Gastroenterology, McAllen, TX; ⁴Dayanand Medical College and Hospital, Chicago, IL; ⁵Jawaharlal Nehru Medical College, Belagavi, Karnataka, India; ⁶Osmania General Hospital and Medical College, Hyderabad, Telangana, India; ⁷Wake Forest University School of Medicine, Charlotte, NC; ⁸Outcomes Research, Atlanta, GA

Introduction: As obesity rates and bariatric surgeries increase especially among older population, it's vital to understand the impact of prior bariatric surgery (BS) on subsequent complex procedures like Endoscopic Retrograde Cholangiopancreatography (ERCP) . Our study aims to understand the impact and prevalence of prior bariatric surgery on ERCP outcomes in elderly obese admission over a 5 year period.

Methods: National Inpatient Sample from 2016-2020 was analyzed, with a focus on elderly obese ( >65 years) with prior BS hospitalized for ERCP and associated complications (post-ERCP pancreatitis, infection, cholangitis, acute kidney injury) using ICD-10 CM codes. Both groups were compared in terms of demographics and comorbidities. Multivariable regression was used to analyze the impact on post-ERCP inpatient outcomes and Impact on healthcare resource utilization.

Results: Of 57,994 elderly obese hospitalized for ERCP, 2.0% (1,175) had prior bariatric surgery (BS).Over the 5-year period, there has been increasing prevalence of BS in elderly population (2.0%), males (1.5%), females (2.4%), low income quartile (1.25%) and decrease in high income quartile (2.1%). Prior BS cohort has similar age (73 yrs), more likely females (72.2% vs 56.8%) and whites (84.1% vs 79.5%), Medicare enrolees (89.7% vs 88.8%), higher median & median quartile (31.2% vs 27.4%; 31.2% vs 25.6%), urban teaching hospitals (86.4% vs 76.8%) and lower elective admissions as compared to non-prior BS. Prior BS cohort was often associated with uncomplicated or complicated hypertension, diabetes without or with chronic complications, hyperlipidemia, smoker, hypothyroidism, depression, cancer or prior history of cancer, chronic kidney disease and lower post-ERCP complications like pancreatitis (6.4% vs 9.1%), secondary infection (8.9% vs 17.75), acute kidney injury [AKI] (14.9% vs 29.7) as compared to non-prior BS (p< 0.05). The prior BS cohort showed lower odds for post-ERCP AKI (OR 0.47 95%Cl 0.31 vs 0.71) and secondary infection (OR 0.58 95%Cl 0.35-0.95) as compared to non-prior BS. The prior BS cohort were routinely discharged (69.4% vs 60.3%) and had higher hospital cost (78318$ vs 77322$) (p< 0.05).

Discussion: Nationwide analysis indicates that prior bariatric surgery is associated with lower odds for developing acute kidney injury and secondary infection in elderly obese patients following ERCP. This study shows that prior bariatric might offer protective role for elderly patients undergoing procedure like ERCP.


Disclosures:


Boney Lapsiwala, MD¹, Pranav Chalasani, MD², Rishika Trivedi, MD³, Sahiljot Bhupal, MBBS⁴, Amrutha Yalla, MBBS⁵, Sahana Bopparaju, ⁶, Shreyans Doshi, MD⁷, Rupak Desai, MBBS⁸. P1053 - Prevalence and Impact of Prior Bariatric Surgery Status on ERCP Outcomes in Older Patients with Obesity: A Population-Based Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.