P4113 - Sex Disparities in Short-Term Complications of Patients Admitted for Hemorrhagic Dieulafoy Lesion of Stomach and Duodenum and Underwent Esophagogastroduodenoscopy

Renuka Verma, MD¹, Kyaw Min Tun, DO², Hemamalini Sakthivel, MD³, Kamleshun Ramphul, MD⁴, Banreet Dhindsa, MD⁵, Douglas Adler, MD^6
1University of Nevada, Las Vegas, NV; ²Creighton University School of Medicine, Las Vegas, NV; ³One Brooklyn Health-Interfaith Medical Center, New York, NY; ⁴Independent Researcher, Triolet, Pamplemousses, Mauritius; ⁵NYU Grossman School of Medicine, New York, NY; ⁶Center for Advanced Therapeutic (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, CO

Introduction: Dieulafoy lesions of the stomach and duodenum are a rare yet significant cause of upper gastrointestinal bleeding, with an estimated mortality rate that can vary to around 4.65%. Esophagogastroduodenoscopy(EGD) is an essential tool in diagnosing and treating such cases. As there are no studies to date evaluating the sex-based differences in complications, we propose a retrospective study via a national database.

Methods: All adults with a primary diagnosis code for Dieulafoy lesion (hemorrhagic) of stomach and duodenum were retained using the ICD-10 code “K3182” from the 2016-2021 National Inpatient Sample(NIS). We further excluded all cases that did not undergo EGD and had missing data for sex. Multivariable logistic regression was used to estimate differences in outcomes while taking into account the impact of known confounders.

Results: There were 7035 cases that matched our selection, consisting of 4085(58.1%) males and 2950(41.9%) females. Females were older than males with a median age of 72.00(IQR:62.00-80.00)(vs. 69.00, IQR 56.00-79.00, p< 0.01). Moreover, Females were more likely to require transfusion of blood/blood products and report events of septicemia while having lower odds of cardiac arrest, cardiogenic shock, and acute kidney injury(AKI). No differences in events of aspiration pneumonia, hemorrhagic shock, acute myocardial infarction, need for mechanical ventilation, and events of acute ischemic stroke were found between the two groups (Table 1). We further found that Females expressed higher odds of all-cause in-patient death (3.7% vs. 2.2%, aOR 1.868, 95% CI 1.352-2.581, p< 0.01).

Discussion: Our study showed that the complications between Females and Males with Dieulafoy lesions of the stomach/duodenum and being treated via EGD varied in our study, as females, who were also older, reported higher odds of needing a transfusion, septicemia, and death while having fewer cases of cardiac arrest, cardiogenic shock, and AKI. We, therefore, advocate for additional retrospective and prospective multicenter studies to establish the links between these disparities and provide adequate solutions to mitigate them.


Disclosures:


Renuka Verma, MD¹, Kyaw Min Tun, DO², Hemamalini Sakthivel, MD³, Kamleshun Ramphul, MD⁴, Banreet Dhindsa, MD⁵, Douglas Adler, MD⁶. P4113 - Sex Disparities in Short-Term Complications of Patients Admitted for Hemorrhagic Dieulafoy Lesion of Stomach and Duodenum and Underwent Esophagogastroduodenoscopy, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.