MedStar Authors catalog › Details for: End-stage renal disease is associated with increased post endoscopic retrograde cholangiopancreatography adverse events in hospitalized patients.
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End-stage renal disease is associated with increased post endoscopic retrograde cholangiopancreatography adverse events in hospitalized patients.

by Cho, Won K.
Citation: World Journal of Gastroenterology. 24(41):4691-4697, 2018 Nov 07..Journal: World journal of gastroenterology.Published: ; 2018ISSN: 1007-9327.Full author list: Sawas T; Bazerbachi F; Haffar S; Cho WK; Levy MJ; Martin JA; Petersen BT; Topazian MD; Chandrasekhara V; Abu Dayyeh BK.UI/PMID: 30416316.Subject(s): Aged | *Cholangiopancreatography, Endoscopic Retrograde/ae [Adverse Effects] | Female | Hospital Mortality | Humans | *Kidney Failure, Chronic/co [Complications] | Length of Stay/ec [Economics] | Length of Stay/sn [Statistics & Numerical Data] | Male | Middle Aged | *Pancreatitis/ep [Epidemiology] | Pancreatitis/et [Etiology] | *Postoperative Hemorrhage/ep [Epidemiology] | Postoperative Hemorrhage/et [Etiology] | Retrospective Studies | Risk FactorsInstitution(s): MedStar Washington Hospital CenterDepartment(s): Medicine/GastroenterologyActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.3748/wjg.v24.i41.4691 (Click here) Abbreviated citation: World J Gastroenterol. 24(41):4691-4697, 2018 Nov 07.Abstract: AIM: To determine if end-stage renal disease (ESRD) is a risk factor for post endoscopic retrograde cholangiopancreatography (ERCP) adverse events (AEs).Abstract: METHODS: We performed a retrospective cohort study using the Nationwide Inpatient Sample (NIS) 2011-2013. We identified adult patients who underwent ERCP using the International Classification of Diseases 9<sup>th</sup> Revision (ICD-9-CM). Included patients were divided into three groups: ESRD, chronic kidney disease (CKD), and control. The primary outcome was post-ERCP AEs including pancreatitis, bleeding, and perforation determined based on specific ICD-9-CM codes. Secondary outcomes were length of hospital stay, in-hospital mortality, and admission cost. AEs and mortality were compared using multivariate logistic regression analysis.Abstract: RESULTS: There were 492175 discharges that underwent ERCP during the 3 years. The ESRD and CKD groups contained 7347 and 39403 hospitalizations respectively, whereas the control group had 445424 hospitalizations. Post-ERCP pancreatitis (PEP) was significantly higher in the ESRD group (8.3%) compared to the control group (4.6%) with adjusted odd ratio (aOR) = 1.7 (95%CI: 1.4-2.1, <sup>a</sup> P < 0.001). ESRD was associated with significantly higher ERCP-related bleeding (5.1%) compared to the control group 1.5% (aOR = 1.86, 95%CI: 1.4-2.4, <sup>a</sup> P < 0.001). ESRD had increased hospital mortality 7.1% vs 1.15% in the control OR = 6.6 (95%CI: 5.3-8.2, <sup>a</sup> P < 0.001), longer hospital stay with adjusted mean difference (aMD) = 5.9 d (95%CI: 5.0-6.7 d, <sup>a</sup> P < 0.001) and higher hospitalization charges aMD = Abstract: CONCLUSION: ESRD is a risk factor for post-ERCP AEs and is associated with higher hospital mortality. Careful selection and close monitoring is warranted to improve outcomes.

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