S3367 Obesity and In-Hospital Outcomes of Endoscopic Retrograde Cholangiopancreatography

Abstract

Introduction: Multiple risk factors associated with post-Endoscopic Retrograde Cholangiopancreatography (ERCP) complications have been investigated in numerous studies. However, there are only a few studies focusing on the relationship between obesity and ERCP outcomes. In our study, we compared the in-hospital outcomes of ERCP in obese vs non-obese patients. Methods: The study cohort is derived from the Nationwide Inpatient Sample (NIS) for the years 2007-2018. Adult patients undergoing ERCP were identified using previously validated ICD-9-CM/ICD-10-CM codes. Procedural complications and other diagnoses of interest were also identified by ICD-9/10-CM codes. We utilized the Chi-Square test, Wilcoxon Rank Sum test, and multivariable survey logistic regression models to analyze the data. Results: We analyzed 1,973,398 ERCP procedures from 2007-2018, out of which 279,620 (14.2%) were performed in obese patients. Proportion of obese patients undergoing ERCP increased from 7.6% in 2007 to 20.0% in 2018 (P < 0.01). Obese patients under going ERCP were younger (53-years vs 60-years; P < 0.01), female (68% vs 57%: P < 0.01) and Hispanic (18% vs 15%; P < 0.01). In univariate analysis, obesity was associated with higher post-ERCP pancreatitis (2.0% vs 1.6%; P < 0.001). Even after adjusting for confounding factors, obesity was associated with a higher risk of post-ERCP pancreatitis (1.2; 95%CI 1.1-1.3; P < 0.01). Detailed comparison of in-hospital outcomes of ERCP in obese vs non-obese has been depicted in Table. Conclusion: We demonstrated the in-hospital outcomes of ERCP in obese vs non-obese patients and found out that obesity is an independent risk factor for post-ERCP pancreatitis and cholangitis. Our study highlights the need for focused interventions to reduce the incidence of these complications to improve the overall outcomes of ERCP in obese patients.Table 1.: In-Hospital Outcomes of ERCP in Obese vs Non- Obese patients.