Abstract No. 580 Overweight, obesity, and unfavorable outcomes after percutaneous biliary interventions: a national study

Abstract

to evaluate the role of obesity on short-term outcomes after inpatient percutaneous biliary interventions including percutaneous transhepatic cholangiography, stone removal and biliary drain placement. We hypothesized that there is a dose-dependent relationship between obesity and unfavorable outcomes after percutaneous biliary interventions. Data from the national inpatient sample consisting of up to 97% of US community hospitals were used for this study. Using the ICD9-CM diagnosis codes and BMI values, patients were categorized into 4 groups: underweight, normal weight, overweight, premorbid obesity and morbid obesity. Hospital related outcomes including mortality, length of stay, disposition and hospital charges were compared among the weight groups. An estimated 23,730 ± 537 inpatient percutaneous biliary interventions were performed in the US from 2012–2015, 7.9% (± 0.4) and 2.6% (± 0.2) of which were on patients with obesity and morbid obesity, respectively. In univariate analysis of the outcomes and compared to non-obese patients, patients with obesity had similar post procedure mortality (3.4% ± 0.9 vs. 3.7% ± 0.3), length of stay (average days: 8.3 ± 0.3 vs. 7.5 ± 0.1), routine disposition (49.7% ± 2.7 vs. 48.3% ± 0.8) and total hospital charges (USD: 76,537 ± 4072 vs. 69,871 ± 1332; all P values >0.05). In multivariable modeling and after adjustment for patients’ demographic characteristics and principal diagnosis (including malignancies and sepsis), obesity was associated with similar probability of death (odds ratio [OR]: 0.98 [0.52–1.84], P:0.96) and routine disposition (OR: 0.93 [0.73–1.18], P:0.57), but higher risk of lengthy hospital stay (>8 days; OR: 1.32 [1.05–1.67], P:0.02) and greater hospital charges (>75,000 USD; OR:1.29 [1.02–1.63], P:0.03). A dose-dependent association between weight category and lengthy hospital stay (OR: 1.11 [1.03–1.18], P <0.01) and greater hospital charges (OR: 1.10 [1.03–1.18], P:0.01) was detected. There is a dose-dependent association between obesity, hospital stay and total hospital charges after percutaneous biliary interventions. Every higher weight category is associated with 10 – 11% higher odds of unfavorable outcomes.