P0686 - Prevalence and Impact of Prediabetes on In-Hospital Post-ERCP Outcomes: Insights From a Population Based Analysis, 2016-2020

Boney Lapsiwala, MD¹, Sai Gautham Kanagala, MD², Rishika Trivedi, MD³, Nikitha Devaprasad, MBBS⁴, Lohithasya Chowdary Chunduru, MBBS⁵, Swathi Veliginti, MD⁶, Arshad Ali Mohd, MBBS⁷, Tahniyath Sumera, MBBS⁸, Shiny Teja Kolli, MD⁹, Shreyans Doshi, MD¹⁰, Rupak Desai, MBBS^11
1Medical City Arlington, Denton, TX; ²NYC Health + Hospitals/Metropolitan, New York, NY; ³DHR Health, Edinburg, TX; ⁴SRM Medical College Hospital and Research Centre, Chennai, Tamil Nadu, India; ⁵Shanthiram Medical College, Nandyal, Andhra Pradesh, India; ⁶Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX; ⁷Deccan College of Medical Sciences, Hyderbad, Telangana, India; ⁸Shadan Institute of Medical Sciences, Hyderabad, Telangana, India; ⁹Jacobi Medical Center/North Central Bronx Hospital, Bronx, NY; ¹⁰Wake Forest University School of Medicine, Charlotte, NC; ¹¹Outcomes Research, Atlanta, GA

Introduction: Diabetes is a known risk factor for post-procedural complications. Poor glycemic control is associated with worse outcomes following Endoscopic Retrograde Cholangiopancreatography (ERCP). This study investigates the prevalence and impact of post-ERCP admissions in elderly patients with prediabetes.

Methods: The National Inpatient Sample (NIS) database (2016-2020) was analyzed to identify post-ERCP geriatric admissions (age >65 years) with prediabetes using relevant ICD-10 codes. We compared demographics, comorbidities, and outcomes of post-ERCP admissions with prediabetes (pDM) versus those without. Primary outcomes included in-hospital mortality and post-ERCP complications. Secondary outcomes were patient disposition, length of stay, and hospital charges.

Results: Of 254,355 geriatric patients undergoing ERCP, 3,895 [median age 72 (70-82)] had prediabetes. The pDM cohort was more likely male (47.3% vs. 46.3%), less likely White (64.8% vs. 81.2%), and had a higher median income quartile (32.1% vs. 24.4%). They were more often enrolled in Medicaid (3.8% vs. 1.9%) and treated in small/medium bed size hospitals (18.7% vs. 15.9%, 29.8% vs. 27.8%) and urban teaching hospitals (86.3% vs. 77.1%), particularly in the West (49.4% vs. 22.3%). The pDM cohort had higher rates of comorbidities including complicated hypertension (29.0% vs. 21.0%), obesity (22.5% vs. 11.7%), and hyperlipidemia (67% vs. 44.2%). Despite higher comorbidity, the pDM cohort had lower in-hospital mortality (0.9% vs. 2.2%, aOR 0.4 [0.18-0.91], p=0.029) and acute kidney injury (17.2% vs. 20.9%, aOR 0.71 [0.57-0.87], p< 0.001) but higher risk for pancreatitis (9.4% vs. 8.3%, p=0.015) and post-ERCP cholangitis (4.9% vs. 4.0%, p=0.009). They were more often routinely discharged (74.2% vs. 61.7%) and had shorter hospital stays (4 days vs. 5 days, p< 0.01) with similar hospitalization costs.

Discussion: Elderly prediabetic patients following ERCP have significantly lower odds of in-hospital mortality and acute kidney injury. This paradoxical protective role of impaired glucose regulation in ERCP outcomes warrants further investigation.


Disclosures:


Boney Lapsiwala, MD¹, Sai Gautham Kanagala, MD², Rishika Trivedi, MD³, Nikitha Devaprasad, MBBS⁴, Lohithasya Chowdary Chunduru, MBBS⁵, Swathi Veliginti, MD⁶, Arshad Ali Mohd, MBBS⁷, Tahniyath Sumera, MBBS⁸, Shiny Teja Kolli, MD⁹, Shreyans Doshi, MD¹⁰, Rupak Desai, MBBS¹¹. P0686 - Prevalence and Impact of Prediabetes on In-Hospital Post-ERCP Outcomes: Insights From a Population Based Analysis, 2016-2020, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.