P2955 - Resource Utilization by Cirrhotic Patients Presenting to the Emergency Department: A Single Center Experience

Mary Ayad, MD¹, Tobi A. Ajumobi, ², Adewale Ajumobi, MD, FACG^1
1Eisenhower Health, Rancho Mirage, CA; ²Rancho Mirage, CA

Introduction: Patients with cirrhosis are prone to many complications that require emergency department (ED) visits and hospitalization. However, adequate information on resource utilization by patients with cirrhosis is lacking. This study aims to evaluate resource utilization by patients with cirrhosis who present to the ED.

Methods: A single-center cross-sectional study was conducted at a large community teaching hospital. It included patients aged 18+ with cirrhosis (ICD-10 codes) who presented to the ED between January 2022 and December 2022.

Data on demographics,insurance status, primary language, presenting complaints, primary diagnosis, length of stay, and in-hospital mortality were collected. Receipt of paracentesis, esophagogastroduodenoscopy (EGD), colonoscopy, nephrology consult, gastroenterology consult, intensive care unit (ICU) stay, 30 day-readmissions, and radiologic or surgical interventions were used as surrogates for resource utilization. Descriptive statistics and Chi-square tests were used for analysis.

Results: The study included 688 patients: 57% male, 54% White Caucasian, 40% married, and 83% English-speaking. The mean age was 65.3 ± 11.9 years (range: 27-95). Most patients had Medicare/Medicare Advantage (60%), followed by Medi-Cal/Medi-Cal HMO (25%).

The most common chief complaints were abdominal pain (13%), altered mentation (11%), and shortness of breath (11%). The mean MELD Na score was 14.64 ± 10.45, and the Charlson Comorbidity Index was 16.33 ± 9.23. Seventeen percent required ICU care, 22% underwent paracentesis, 12% had an EGD, 2% had a colonoscopy, 14% had nephrology consultation, 12% had gastroenterology (GI) consultation, and 10% underwent surgical intervention. The mean length of stay was 4.7 ± 4.87 days (range: 1-29), median 3 days. In-hospital mortality was 3.78%. About 24% were readmitted within 30 days. Receipts of paracentesis or GI consultation were associated with 30-day readmissions.

Discussion: Resource utilization is high in cirrhotic patients presenting to the ED. Almost 4% of these patients die during hospitalization and almost a quarter will be readmitted within 30 days. Prioritizing the prevention and treatment of ascites and hepatic encephalopathy is essential to reduce healthcare costs.


Disclosures:


Mary Ayad, MD¹, Tobi A. Ajumobi, ², Adewale Ajumobi, MD, FACG¹. P2955 - Resource Utilization by Cirrhotic Patients Presenting to the Emergency Department: A Single Center Experience, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.