03906nam 22005537a 4500008004200000022001400042024003500056024002100091040002000112099001300132245015000145251007000295252005800365253003800423260000900461260001100470265001300481266001500494520015800509520017900667520065000846520089801496546001202394650007402406650004802480650003602528650004802564650000902612650001102621650002302632650001102655650003402666650005202700650000902752650001602761650003102777650004302808650002602851650001702877651003902894656003002933657002002963700001502983790012302998856009303121942001703214952010603231999001503337181116s20182018 xxu||||| |||| 00| 0 eng d a1007-9327 a10.3748/wjg.v24.i41.4691 [doi] aPMC6224476 [pmc] aOvid MEDLINE(R) a30416316 aEnd-stage renal disease is associated with increased post endoscopic retrograde cholangiopancreatography adverse events in hospitalized patients. aWorld Journal of Gastroenterology. 24(41):4691-4697, 2018 Nov 07. aWorld J Gastroenterol. 24(41):4691-4697, 2018 Nov 07. aWorld journal of gastroenterology c2018 fFY2019 sppublish d2018-11-16 aAIM: To determine if end-stage renal disease (ESRD) is a risk factor for post endoscopic retrograde cholangiopancreatography (ERCP) adverse events (AEs). aCONCLUSION: 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. aMETHODS: 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 9th 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. aRESULTS: 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, a 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, a 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, a P < 0.001), longer hospital stay with adjusted mean difference (aMD) = 5.9 d (95%CI: 5.0-6.7 d, a P < 0.001) and higher hospitalization charges aMD = +82064 (95%CI: 68221-95906, a P < 0.001). aEnglish a*Cholangiopancreatography, Endoscopic Retrograde/ae [Adverse Effects] a*Kidney Failure, Chronic/co [Complications] a*Pancreatitis/ep [Epidemiology] a*Postoperative Hemorrhage/ep [Epidemiology] aAged aFemale aHospital Mortality aHumans aLength of Stay/ec [Economics] aLength of Stay/sn [Statistics & Numerical Data] aMale aMiddle Aged aPancreatitis/et [Etiology] aPostoperative Hemorrhage/et [Etiology] aRetrospective Studies aRisk Factors aMedStar Washington Hospital Center aMedicine/Gastroenterology aJournal Article aCho, Won K aAbu Dayyeh BK, Bazerbachi F, Chandrasekhara V, Cho WK, Haffar S, Levy MJ, Martin JA, Petersen BT, Sawas T, Topazian MD uhttps://dx.doi.org/10.3748/wjg.v24.i41.4691zhttps://dx.doi.org/10.3748/wjg.v24.i41.4691 cARTdArticle 001040708Articleaauthcatbauthcatd2018-11-16l0o30416316p30416316r2018-11-16w2018-11-16yART c3905d3905