THE PRESENCE OF CARDIAC ARRHYTHMIAS IS ASSOCIATED WITH INCREASED MORTALITY IN HOSPITALIZED PATIENTS WHO ARE UNDERGOING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) WITH A CONCURRENT DIAGNOSIS OF IBD

Abstract

Abstract BACKGROUND Patients with inflammatory bowel disease (IBD) undergoing ERCP can be prone to having worse hospital outcomes due to certain comorbidities. There are limited studies that have examined the impact of cardiac arrhythmias on patients with IBD undergoing ERCP. The aim of our study was to identify the impact of cardiac arrhythmias on outcomes for this patient population. METHODS Patients aged 18 years or older with a diagnosis of IBD, ERCP, and cardiac arrhythmias were identified from the US Nationwide Inpatient Sample (NIS), from the years 2015-2019, using ICD 10 codes. Multivariate regression analysis was used to estimate the odds ratios of in-hospital mortality, the average length of hospital stay, and hospital charges, after adjusting for age, gender, race, primary insurance payer status, hospital type, and size (number of beds), hospital region, hospital teaching status, and other demographic characteristics. Weighted analysis utilizing Stata 17 MP was performed. RESULTS This study identified approximately 410,100 patients with IBD who underwent ERCP from the years 2015 to 2019. Of these patients, 2,115 had cardiac arrhythmias (atrial flutter, atrial fibrillation, ventricular tachycardia, and supraventricular tachycardia). The mean age of patients was 57.62 years. The analysis revealed that mortality was increased (OR 5.70, p= 0.008, CI: 1.59- 20.44), but the differences in length of stay (LOS) and total hospital charges (THC) were not statistically significant (p>0.05) for patients with IBD undergoing ERCP compared to patients with IBD undergoing ERCP who had cardiac arrhythmias. Independent positive predictors of mortality, LOS, and increased total hospital charges were sepsis and acute kidney injury. CONCLUSION(S) Our study shows that patients with IBD undergoing ERCP, and cardiac arrhythmias increased mortality, but did not impact hospital LOS or total hospital charges. Based on our study results, patients with cardiac arrhythmias need closer monitoring and there needs to be a focus on better treating and controlling cardiac arrhythmias that may develop. Future studies should explore the impact of each type of cardiac arrhythmia on outcomes and then there can be further risk stratification based on the type of cardiac arrhythmia present.