Ahmad Nawaz, MD1, Christina Bennett, MD1, Abdelkader Chaar, MD1, Azhar Hussain, MBBS1, Fatima Khalid, MBBS2, Umar Hayat, MD3, Kelita Singh, MD1, Ganesh Aswath, MD1, Hafiz Muzaffar Akbar Khan, MD1 1SUNY Upstate Medical University, Syracuse, NY; 2Fatima Memorial Hospital, Lahore, Punjab, Pakistan; 3Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA
Introduction: Obesity-related Endoscopic Retrograde Cholangiopancreatography (ERCP) adverse events are well documented in the literature, but there is no data about adverse events related to Low Body Mass Index (LBMI). We designed a study to compare the outcomes of patients undergoing ERCP with LBMI.
Methods: We conducted a retrospective cohort study using TriNetX, a multi-institutional database. We identified patients who underwent ERCP using appropriate ICD 9 and 10 codes. The data was collected from November 2000 to June 2024. Patients who underwent ERCP were divided into two groups: Low Body Mass Index Group (LBMI: BMI < 19.9 kg/m2) and non-obese control group (BMI 20-29kg/m2). One-to-one (1:1) propensity score matching was performed. The primary endpoints were to assess the risk of post- ERCP pancreatitis, aspiration pneumonia, mechanical ventilation requirement, vasopressor support and initiation of dialysis within 30 daysbetween the two groups. The secondary outcome was 30-day mortality. Risk was expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).
Results: There were 9,105 patients in LBMI cohort and 30,165 patients in non-obese cohort prior to propensity score matching and 9,105 patients in each cohort group after propensity score matching. In LBMI group, there was a decreased risk of post ERCP pancreatitis [OR 0.79 (95% CI 0.72 - 0.87)] but an increased risk of aspiration pneumonia [OR 2.04 (95% CI 1.52 - 2.74)], mechanical ventilation [OR 1.72 (95% CI 1.25 - 2.37)], initiation of dialysis [OR 1.65 (95%CI 1.19 - 2.30)] as well as 30- day mortality [OR 2.14 (95% CI 1.86- 2.46)] when compared to non-obese control group who underwent ERCP as shown in the table.
Discussion: Our study identifies that patient with low body mass index who undergo ERCP though have a lower risk of post-ERCP pancreatitis as compared to non-obese group but are at a higher risk of aspiration pneumonia, mechanical ventilation, dialysis, and death. Low BMI patients will benefit from risk stratification before undergoing ERCP.
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Ahmad Nawaz indicated no relevant financial relationships.
Christina Bennett indicated no relevant financial relationships.
Abdelkader Chaar indicated no relevant financial relationships.
Azhar Hussain indicated no relevant financial relationships.
Fatima Khalid indicated no relevant financial relationships.
Umar Hayat indicated no relevant financial relationships.
Kelita Singh indicated no relevant financial relationships.
Ganesh Aswath indicated no relevant financial relationships.
Hafiz Muzaffar Akbar Khan indicated no relevant financial relationships.
Ahmad Nawaz, MD1, Christina Bennett, MD1, Abdelkader Chaar, MD1, Azhar Hussain, MBBS1, Fatima Khalid, MBBS2, Umar Hayat, MD3, Kelita Singh, MD1, Ganesh Aswath, MD1, Hafiz Muzaffar Akbar Khan, MD1. P4474 - ERCP Outcomes in Patients With Low Body Mass Index: A Propensity Score-Matched Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
