S3269 Common Presentations and Outcome of Eosinophilic Esophagitis in United States: Nationwide Inpatient Cohort Study

Abstract

Introduction: Eosinophilic esophagitis (EoE) is a newly described disorder characterized by esophageal dysfunction and eosinophilic infiltration of the esophagus, once considered a rare entity, is becoming a commonly encountered gastroenterological condition. In addition to increased clinical recognition of EoE, rising EoE related hospitalization in the United States has been reported. We aimed to identify the most common presentations, medical and surgical outcomes Methods: A retrospective analysis utilizing the de-identified data from the National Inpatient Sample (NIS) was used to analyze patients hospitalized with Eosinophilic esophagitis as a primary admission diagnosis from 2004 through 2014. Hospital encounters for EoE were identified using the International Classification of Diseases (ICD-9) diagnostic codes; '53013'. The NIS is a component of the Healthcare Cost and Utilization Project, a national health care database developed through a partnership among federal and state governments and health care institutions sponsored by the Agency for Healthcare Research and Quality. We extracted the most common presentations, in-hospital diagnostic procedures, medical and surgical outcomes. Results: A total of 625,380 patients with a principal diagnosis of Eosinophilic Esophagitis were obtained through data analysis (2004 through 2014). The majority of the patients were between 35 and 79 years old, the most common presentations were: 49.6% presented with gastroesophageal reflux disease symptoms, 8.3% presented with dysphagia, 5.6% with atypical chest pain, 5.1% with vomiting, 4.1% with weight loss &failure to thrive, 3.7% with abdominal pain, and 1% with acute food impaction. Interesting associations with the EoE were asthma (4.7%), Food allergy (2.7%), and Atopic dermatitis (0.8%). 44.9% of the patients had Upper Endoscopy and Biopsy upon the same admission. The most common EGD findings were: Esophageal plaques or Candida (8.2%), Esophageal strictures (5%), Esophageal Furrows (4.7%), Steroid Use Induced infection (4.6%), Esophageal Ulceration (4 %), and esophageal rings (0.7%). Conclusion: In summary, national databases such as the NIS are handy tools to address questions surrounding low-frequency events like the EoE and outcomes that would otherwise escape study on a nationally representative level. However, caution must be used when interpreting results, as they are subject to several limitations.Table 1.: We Analyzed from the NIS data the most common presentations, in-hospital diagnostic procedures, medical and surgical outcomes between the years 2004 through 2014.