Predictors of Morbidity, Mortality, and Hospital Utilization Among Endoscopic Retrograde Cholangiopancreatography–related Hospitalizations

Yassine Kilani, Mahmoud Y. Madi, Saqr Alsakarneh, Priscila Castro Puelo, Mohammad Aldiabat, Kym Yves Syrilan, Mariana Nunez Ferreira, Daniel Alejandro Gonzalez Mosquera, Amir H. Sohail, Laith Numan, Marina Kim, Wissam Kiwan

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We aimed to assess the hospital frailty risk score on the inpatient mortality, morbidity, and health care resource utilization among endoscopic retrograde cholangiopancreatography (ERCP)related hospitalizations. Background: Data regarding the inpatient mortality, morbidity, and health care resource utilization of ERCP among frail individuals remain limited. Materials and Methods: Using the Nationwide Inpatient Sample, we compared the odds of inpatient mortality and morbidity of ERCP-related hospitalizations among individuals with low frailty scores, intermediate frailty scores (IFSs), and high frailty scores (HFSs). Results: Overall, 776,025 ERCP-related hospitalizations were recorded from 2016 to 2020. 552,045 had a low frailty score, whereas 217,875 had an IFS, and 6105 had an HFS. Frail individuals had a 5-fold increase in mortality [IFS: adjusted odds ratio (aOR) = 4.81, 95% CI: 3.77-6.14; HFS: aOR = 4.62, 95% CI: 2.48-8.63]. An IFS was associated with a 24% increase in post-ERCP pancreatitis (aOR = 1.25, 95% CI: 1.11-1.41), a 3-fold increase in post-ERCP bleeding (aOR = 2.59, 95% CI: 1.82-3.67), and a 2-fold increase in post-ERCP duct perforation (aOR = 1.91, 95% CI: 1.38-2.64). Frail individuals experienced higher odds of in-hospital morbidity, including secondary sepsis, respiratory failure, acute kidney injury, cerebrovascular accidents, deep vein thrombosis, and pulmonary embolism. Conclusions: In summary, our study presents strong evidence in support of using the hospital frailty risk score as an index to predict mortality and morbidity during ERCP-related hospitalizations. Additional caution is warranted in the management of frail individuals undergoing ERCP.

Original languageEnglish
Article number10.1097/MCG.0000000000002058
JournalJournal of Clinical Gastroenterology
DOIs
StateAccepted/In press - 2024

Keywords

  • endoscopic retrograde cholangiopancreatography
  • frailty
  • hospital frailty risk score
  • morbidity
  • mortality

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