(310) Nationwide Priapism Emergency Department Encounters in the United States

Abstract

Abstract Introduction There is a lack of understanding of recent trends and costs in emergency department visits and inpatient admissions for priapism. In particular no studies have evaluated nationwide trends in priapism since the roll out of ICD-10CM coding in 2015. Objective To determine contemporary national estimates for emergency department visits and inpatient admissions for priapism in the United States from 2016-2019. Methods Emergency department (ED) encounters for priapism were analyzed using the Nationwide Emergency Department Sample (NEDS) from the Healthcare Cost and Utilization Project (HCUP). Patients presenting to the ED with a diagnosis of priapism were identified by ICD-10-CM codes. Patient demographics, hospital characteristics, patient disposition, and costs were evaluated for each visit. Statistical analysis was performed using established weighting provided by the HCUP to create national estimates. Comparisons of demographics were performed using t-tests and chi-square tests with a p-value for significance <0.05. Prolonged length of stay was defined as over two days. Results Between 2016-2019, there was a weighted total of 78,993 ED visits for priapism nationwide out of an estimated 576,544,259 ED encounters making up 0.014% (p<0.01) of all ED encounters. The average age of a patient diagnosed with priapism was 41 (SEM=0.102). Patients diagnosed with unspecified priapism made up 73.67% (58,197) of encounters, while those diagnosed with drug-induced priapism accounted for 14.34% (11,325) of encounters, and 7.26% (5,738) encounters of priapism were due to disease. The South region had the greatest number of priapism encounters each year accounting for 46.59% (36,800) of all ED visits mostly in metropolitan teaching hospitals hosted 70.53% (55,713). Inpatient admissions occurred in 16.07% (12,696) of ED visits for priapism. Of those admitted, 79.10% (10,043) had a prolonged length of stay with those staying only a day making up 16% (2,031). Inpatient admissions averaged a total charge of $72,668 compared with $3,763 (p<.0001) for patients not admitted. Of the expected primary payers, private insurance covered 32.14% (25,356) of ED visits for priapism with Medicaid covering 30.24% (23,857), Medicare covering 17.50% (13,805), and self-payers covering 14.77% (11,648). Conclusions ED visits for priapism remain a frequent and costly event in the United States Healthcare System. Patients requiring inpatient admission leads to a significantly increased cost for the overall encounter. Future studies should examine interventions that can decrease repeated ED visits and inpatient admission for priapism on a regional and national level. Disclosure No