P4180 - Paradoxical Disparities in Complications After Esophagogastroduodenoscopy for Upper Gastrointestinal Bleeding in Patients with Hearing Loss

Kamleshun Ramphul, MD¹, Renuka Verma, MD², Kyaw Min Tun, DO³, Hemamalini Sakthivel, MD⁴, Banreet Dhindsa, MD^5
1Independent Researcher, Triolet, Pamplemousses, Mauritius; ²University of Nevada, Las Vegas, NV; ³Creighton University School of Medicine, Las Vegas, NV; ⁴One Brooklyn Health-Interfaith Medical Center, New York, NY; ⁵NYU Grossman School of Medicine, New York, NY

Introduction: Upper gastrointestinal bleeding (UGIB) is an acute emergency that requires proper management and care in a timely fashion. It is believed that hearing impaired(HI) patients may be at a disadvantage in critical situations due to the lack of translators or access to communicate. Our study aims to evaluate how patients with hearing loss fared following esophagogastroduodenoscopy(EGD) due to UGIB in the United States.

Methods: Our retrospective analysis contained adults with a primary diagnosis code for UGIB, as advised in past studies, through the 2016 to 2021 National Inpatient Sample. To better understand the impact of hearing loss on such outcomes, we restricted our HI group to patients with bilateral hearing loss and excluded other forms of hearing loss from our non-HI group. The use of EGD among HI patients and the complications seen following the procedure were calculated via logistic regression models, taking into account various confounders.

Results: There were an estimated 1983444 cases of UGIB, involving 7865(0.40%) patients with HI, who were older (mean age 78.36 vs. 66.93). Among these, 1020930 (51.5%) underwent EGD, with a slightly lower odds of use among patients with HI(3800 cases,0.37%, aOR 0.924, 95% CI 0.882-0.967, p< 0.01). EGD among HI patients resulted in fewer cases of acute kidney injury(AKI)(aOR 0.727, 95% CI 0.671-0.788), while showing no differences for events of cardiogenic shock, acute myocardial infarction(AMI), acute ischemic stroke(AIS), septicemia, or aspiration pneumonia. Finally, we further found that HI patients undergoing EGD reported reduced odds of mortality(aOR 0.731, 95% CI 0.551-0.969, p=0.03)(Table 1).

Discussion: While the reduced odds of EGD among HI cases could be linked with their older age, other causes and potential disparities in access should be evaluated via additional studies. No differences in complications were seen among HI and non-HI patients undergoing EGD for UGIB other than lower odds of AKI and mortality. Additional studies are warranted to understand the challenges faced by HI patients with UGIB prior to and following their admissions and the appropriate steps that can be taken to help them.


Disclosures:


Kamleshun Ramphul, MD¹, Renuka Verma, MD², Kyaw Min Tun, DO³, Hemamalini Sakthivel, MD⁴, Banreet Dhindsa, MD⁵. P4180 - Paradoxical Disparities in Complications After Esophagogastroduodenoscopy for Upper Gastrointestinal Bleeding in Patients with Hearing Loss, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.