Su1506 Systematic Evaluation of the Complication Rate Following Endoscopic Biopsy of the Major Papilla

Abstract

(SD) and median (range) were computed for continuous variables and frequency distributions were calculated for all categorical variables. All statistical tests were twotailed with p!0.05 considered to be significant. Results: Patients who underwent ETI for airway protection were more likely to have a history of liver cirrhosis (36 [40%] vs. 15 [21.7%], pZ0.017), massive hematemesis (O500 ml of bloody emesis20 [22%] vs.7 [8.7%], pZ0.003], alcoholism (38 [43%] vs. 12 [17.4%], p!0.0001), gastro-esophageal varices (35 [39%] vs. 16 [23.2%], pZ0.03), hepatic encephalopathy (13 [15%] vs. 3 [4.3%], pZ0.03), sepsis (28 [31%] vs. 3 [4.3%], p!0.0001), and placement of Sengstaken-Blakemore (SB) tube (8 [9%] vs. none, pZ0.009). Pulmonary aspiration was more frequent in the intubated group (36 [40%] vs. 4 [5.8%], p!0.0001). A risk score was calculated using seven variables: liver cirrhosis [score of 1], massive hematemesis or frequent blood transfusions (O3 units, score of 1), presence of varices [score of 1], alcoholism [score of 1], encephalopathy [score of 1], sepsis [score of 1] and placement of SB tube [score of 1]. The cumulative risk score among the intubated group was (1.77 vs. 0.71, p!0.0001) -higher than that of the non-intubated group. Conclusion: Pulmonary aspiration is common complication in patients with UGIB admitted to ICU undergoing EGD. It is frequently associated in patients who are cirrhosis (1), varices (1), encephalopathy (1), alcoholism [(1), hematemesis/ repeated transfusions (1), sepsis (1) and placement of SB tube (1). A risk score using these variables might guide a clinician to use ETI to protect the airways. A score of 2 or more indicates higher risk of pulmonary aspiration, while a score of less than 1 indicates lower risk. A large prospective study to identify the amount of risk contributed by each of the above risk factors might be useful in the future.