P4506 - Weekends vs Weekdays: A Retrospective Comparison of ERCP Outcomes

Conor Banta, MS¹, Subash Ghimire, MD², Amlish Gondal, MD², Rasmita Budhathoki, MD², Tsu Jung Yang, MD², Noah West, MS³, Madeline Mylod, MS³, Vivian Deng, MS³, Sohaib Shabih, MD², Daebin Im, MD, MPH², Michael Georgetson, MD², Thomas McDonald, MD^2
1Geisinger Commonwealth School of Medicine, Scranton, PA; ²Guthrie Robert Packer Hospital, Sayre, PA; ³Lake Erie College of Osteopathic Medicine, Sayre, PA

Introduction: Throughout the United States, in-hospital provider availability varies over a week, with weekends typically having the fewest available providers. As such, fewer procedures are performed on the weekends due to limited resources. Unfortunately, this may result in differential patient outcomes due to a variety of secondary factors including increased time elapsed to evaluation and procedural intervention. Currently, there is a paucity of data comparing the difference in outcomes between patients undergoing ERCPs on weekends vs those undergoing ERCPs on a weekday.

Methods: We performed a retrospective, single-center review of patients who underwent ERCP at a tertiary care hospital over a period of the past 10 years. Patients undergoing ERCP for any indication on weekdays vs weekends were analyzed. Primary outcomes measured were post-procedural: complications, mortality, ICU admission, transfusion requirement, cardiac arrest, and ventilator requirement, with secondary outcomes including hospital readmissions. We analyzed these variables using Chi-square analysis and a linear regression model (SPSS v.26).

Results: Out of a total 2741 patients identified, a total of 60 ERCP procedures were performed over the weekend. 68% of these patients were females. Respective distribution of baseline comorbidities was similar in weekend vs weekday groups with regards to BMI (30.4+6.7, 33.6±11.7, p= 0.91), age (58.8±17.3, 63.84±15.8, p= 0.07), CAD (20% vs 30.0, p=.07), CKD (8.3% vs 14.1%, p=.20), COPD (8.3% vs 12.3%, p= .35), and diabetes (20% vs 28.4, p=.15). Hypertension was more common in the non-weekend group (41.6% vs 55.1%, p=0.03). The most common indication for weekend ERCP was acute cholangitis (41%). ICU admission risk was higher for procedures done over the weekend (X2= 3.763, p=0.0342) and patients undergoing weekend ERCPs had significantly longer hospital stays (5.1±5.6 vs 3.2±5.1, p=0.005). Procedure time was similar in both groups (65.6±33 versus 66.4±22.9, p= 0.84). There was no difference in post-ERCP death, 30 day-readmission, cardiac arrest or post-ERCP pancreatitis.

Discussion: ERCPs performed on weekends were associated with significantly more postoperative complications and ICU admissions compared to ERCPs performed on weekdays. This study highlights the need for hospital policies to be in place to avoid differential patient outcomes for procedures performed on the weekend compared to the weekday despite known differences like provider availability.


Disclosures:


Conor Banta, MS¹, Subash Ghimire, MD², Amlish Gondal, MD², Rasmita Budhathoki, MD², Tsu Jung Yang, MD², Noah West, MS³, Madeline Mylod, MS³, Vivian Deng, MS³, Sohaib Shabih, MD², Daebin Im, MD, MPH², Michael Georgetson, MD², Thomas McDonald, MD². P4506 - Weekends vs Weekdays: A Retrospective Comparison of ERCP Outcomes, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.