Tu1039 ADVERSE EVENTS AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR GASTRIC NEOPLASMS: A POPULATION-BASED STUDY

Abstract

Endoscopic submucosal dissection (ESD) is an attractive method in the treatment of early gastric neoplasms. But adverse events (AEs) following gastric ESD is inevitable. Many studies addressing AEs were conducted based on single cohort. However, little is known about AEs associated with gastric ESD in population-based studies. This study aimed to identify incidence of AEs following gastric ESD and their risk factors using a large population-level database. We conducted a population-based study for ESD claims based on the Korean Health Insurance Review and Assessment database from 2013 to 2017. This study included subjects who underwent gastric ESD for benign and malignant gastric tumors. We measured incidence rates of bleeding, perforation and pneumonia within 30 days after gastric ESD. We determined the operational definition of each AE as diagnosis or treatment claim code related to AE. Pre-existing comorbidities were determined by Charlson’s comorbidity index (CCI) score calculated from the ICD-10 codes within 3 months before procedure. The logistic regression analysis was used to identify predictors of each adverse event. Finally, we analyzed about 72,647 ESD cases. Pooled incidence rates were 6.650% for bleeding, 0.291% for perforation, and 0.496% for pneumonia. All AEs were predominant in male (all P < 0.05). Bleeding and perforation occurred more frequently in the 40s and 50s than older people. In contrast, incidence of pneumonia steadily increased with age. All AE rates were higher in general hospitals than tertiary hospitals and hospitals. Likewise, as the CCI score increased, the incidence of all AEs increased (Table 1). This population-based study demonstrated that male and comorbid patients were risk factors for the all AEs associated with gastric ESD. In addition, we identified that age group and hospital setting affect the incidence of AEs.