P3335 - Impact of Enteral Nutrition in Refractory Gastroparesis on Healthcare Utilization, Outcomes, and Thirty-Day Readmissions Using the Nationwide Readmission Database

Shahryar Khan, MD¹, Mashal Alam Khan, MBBS², Hamza Asif, MD³, Usama Ali, MBBS⁴, Aamer Syed, ⁵, Amina Arif, MD^6
1University of Kansas, Overland Park, KS; ²Khyber Medical University, Overland Park, KS; ³Khyber Teaching Hospital, Peshawar, North-West Frontier, Pakistan; ⁴Pak International Medical College Peshawar, Mardan, North-West Frontier, Pakistan; ⁵Khyber Medical College, Peshawar, North-West Frontier, Pakistan; ⁶University of Nevada, Reno School of Medicine, Peshawar, North-West Frontier, Pakistan

Introduction: Gastroparesis (GP) is a challenging disease to manage due to lack of clear understanding and pharmacologic agents have shown to have limited efficacy with concerning safety profile. Nutritional status and the treatment of malnutrition are important in gastroparesis. Eventually, patients with refractory gastroparesis require enteral nutrition (EN) through feeding tube placement. However, its role in improving overall survival and outcomes in refractory gastroparesis is still under debate. This article will be centered on healthcare utilization, outcomes, and 30-day readmission rates for patients with EN in GP at a national level in the United States.

Methods: We performed a retrospective cohort study of patients with EN in refractory gastroparesis using Nationwide Readmission Database from 2018-2020. A readmission was defined as the first admission to any hospital for any non-trauma diagnosis within 30 days of the index admission. The outcomes of interest were rate of all-cause readmission within 30 days of discharge, reasons for readmission, mortality, resource use including length of stay (LOS) and total hospitalization charges (THC). Multivariable cox regression analysis to predict the risk factors for early readmission included clinically relevant variables with p< 0.05 from univariate analysis.

Results: The number of admissions for GP was 36235, of which 20% have diagnosis of malnutrition and 3.24% receiving EN. Our study indicated that patients admitted with EN were younger (41.20 vs 46.08), and more likely to be female (80.4% vs 76.9%). In Index admissions, there was no significant difference in mortality of patients between both groups (adjusted odds ratio 1.58, 95% CI 0.59-4.24), but EN was associated with longer LOS (adjusted mean difference 5.38, p < 0.05), and higher THC (adjusted mean difference 56539, p < 0.05). The 30-day readmission rate in GP with EN was 7.35%, and without EN was 6.96%. The most common principal diagnosis for readmissions was GP. Independent predictors of readmission were female, age, diabetes, obesity, insurance, Median household income, and malnutrition (Table 1).

Discussion: In our large real-life cohort, we found the rate of readmissions in gastroparesis with EN was high and associated with higher resource utilization. Multiple predictors were associated with 30-day readmission after index admission and can guide in orchestrating guidelines, treatment protocols, and policy changes in preventing readmission in these population.


Disclosures:


Shahryar Khan, MD¹, Mashal Alam Khan, MBBS², Hamza Asif, MD³, Usama Ali, MBBS⁴, Aamer Syed, ⁵, Amina Arif, MD⁶. P3335 - Impact of Enteral Nutrition in Refractory Gastroparesis on Healthcare Utilization, Outcomes, and Thirty-Day Readmissions Using the Nationwide Readmission Database, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.